SWI在高血压患者伴发脑内微出血的诊断应用

The Application of SWI in Diagnosing Cerebral Microbleeds Correlated with Hypertension

目的了解高血压患者伴发脑内微出血(CMBs)在磁敏感加权成像(SWI)上的表现,并探讨其与高血压水平、白质疏松程度、伴发梗死和叶性出血的关系及其病理基础。资料与方法对59例高血压患者行SWI,观察CMBs在SWI上的表现,对其数目和分布进行统计并进一步与临床和其他影像资料进行相关分析。结果59例共检出35例(59%)CMBs,CMBs呈典型顺磁性物质相位图改变。CMBs主要分布于皮层和皮层下(1,0～5)、基底节区(3,0～10);脑内有CMBs组平时收缩压水平为(154.4±15.0)mmHg(1mmHg=0.133kPa)和平时舒张压水平为(92.6±12.6)mmHg均高于无CMBs组;不同级别白质疏松者相对应的CMBs数目有显著性差异;有伴发梗死或出血组的CMBs数目高于无伴发组。结论SWI有助于显示CMBs;高血压患者CMBs主要分布于基底节区以及皮层和皮层下区;CMBs的出现和多少间接反映了脑内细微穿支动脉的受损程度。

Objective To explore the SWI appearances of cerebral microbleeds（CMBs） in hypertension patients and relationship between the SWI findings and hypertension level, leukoaraiosis, associated infarction and lobular hemorrhage. Materials and Methods SWI was completed in 59 cases with hypertension. The appearances of CMBs in phase and negative mask images were analyzed. The relationship between number and distribution of CMBs, clinical fingdings and other imaging findings were also analyzed. Results CMBs were found in 35 cases（59% ）. CMBs presented with typical appearances of paramagnetic material in phase images. CMBs mainly located at cortex or subcortex （ 1,0 - 5 ）, basal ganglia region （ 3,0 - 10）. Average systolic pressure level（ 154.4 ± 15.0 ） mmHgand diastolic pressure level （92.6 ± 12.6 ） mmHg in 35 cases with CMBs were higher than those in 24 cases without CMBs. There was significant difference in number of CMBs between patients with different degree leukoaraiosis. Number of CMBs in patients with stroke was more than that in patients without associated diseases. Conclusion SWI was helpful in the detection of CMBs. CMBs in patients with hypertension mainly located in basal ganglia region, cortex and subcortex. The presence and number of CMBs might reflect degree of the damage of cerebral small perforating branches.