3.0T DWI对急性脑出血的诊断价值

Detection of acute intracranial hemorrhage with diffusion-weighted echo-planar sequences on 3.0T MRI

目的:探讨3.0T MR机的弥散加权-平面回波成像(DW-EPI)对急性脑出血(AIH)的诊断价值。材料和方法:回顾性分析29例经临床确诊的AIH患者的MRI和CT图像,MRI和CT在发病后24h～1周内完成,MRI包括DW-EPI及常规MRI序列,其中13例加扫了GRE-T2WI。分析并比较B0(b=0s/mm2)、B1000(b=1000s/mm2)、CT及GRE-T2WI诊断AIH的阳性结果。结果:25例脑实质出血患者中,B0、B1000、CT的阳性显示率分别为96%(24例)、84%(21例)、76%(19例),7例蛛网膜下腔出血(包括3例脑实质出血破入脑室)的阳性显示率分别为100%(7例)、57%(4例)、86%(6例)。13例AIH的GRE-T2WI序列均显示为阳性结果。统计学结果显示B0、B1000及CT对AIH的显示能力差异无显著性。结论:3.0TDW-EPI序列是诊断AIH的有效方法之一,可以取代CT。

Objective： To study the value of diffusion-weighted echo-planar imaging （DW-EPI） of 3.0T MRI on acute intracranial hemorrhage （AIH）. Materials and Methods： MRI and CT materials of 29 cases with AIH were reviewed. MRI and CT were performed 24hrs to one week within symptom onset included DW-EPI, routine conventional MR series and axial CT scan. GRE-T2WI was performed on 13 cases of 29 cases. Images of B0（b=0s/mm^2）, B1000（b=1000s/mm^2）, CT and GRE-T2WI series were analysed. Results： There were 24（96%）, 21（84%）, 19（76%） cases that showed positive appearance by B0, B1000 and CT in 25 cases with intraparenchymal hemorrhage, respectively. Seven（100%）, 4（57%）, 6（86%） cases were detected by B0, B1000 and CT in 7 cases with subarachnoid hemorrhage which involved 3 cases of intraparenchymal hemorrhage associated with intra-ventricular involvement, respectively. All 13 cases with GRE-T2WI got positive outcomes. The ability of detection of AIH with B0, B1000 and CT have no significant difference, statistically. Conclusions： DW-EPI is one of the effective imaging sequences in the diagnosis of AIH and may replace CT scans.