3.0T磁敏感加权成像诊断脑梗死后脑出血的价值

Clinical Value of 3.0T MR Susceptibility Weighted Imaging in the Diagnosis of Intracerebral Hemorrhage after Infarction

目的:探讨3.0T磁敏感加权成像(SWI)对梗死后脑出血的诊断价值。方法:对50例急性脑梗死后疑有脑出血患者行CT检查,同时行MRI常规序列(T2WI、T1WI、DWI)扫描及SWI扫描,对检查结果进行统计学分析。结果:34例患者CT扫描证实为梗死后脑出血,SWI诊断脑出血34例,T2WI诊断19例,T1WI诊断21例,DWI诊断25例。SWI、T2WI、T1WI和DWI诊断梗死后脑出血的敏感度分别为100.0%、59.0%、61.4%和73.0%,特异度分别为100.0%、65.2%、68.0%和65.3%,阳性预测值分别为100.0%、68.1%、71.0%和75.4%,阴性预测值分别为100%、60.3%、57.2%和78.3%,约登指数(正确指数)分别为1.0、0.24、0.29和0.38。诊断试验秩和比法分析示SWI、T2WI、T1WI和DWI各序列的秩和比值(RSR)分别为1.0、0.3、0.5和0.7。结论:SWI诊断梗死后脑出血比MRI常规扫描序列具有更高的临床应用价值,可作为急性脑梗死及溶栓治疗后常规复查方法。

Objective：To investigate the clinical value of 3.0T susceptibility weighted imaging （SWI） in the diagnosis of post-infarct cerebral hemorrhage.Methods：50 patients with suspected cerebral hemorrhage after acute cerebral infarct underwent CT examination and conventional MR sequence （T2WI,T1WI,DWI） as well as SWI simultaneously,the results were statistically analyzed.Results：Of the 34 patients had post-infarct cerebral hemorrhage proved by CT,cerebral hemorrhage was diagnosed by SWI （34 patients）,T2WI （19 patients ）,T1WI （21 patients） and DWI （25 patients）.The sensitivity of diagnosing cerebral post-infarct hemorrhage by SWI,T2WI,T1WI and DWI was 100%,59%,61.4% and 73% respectively;the specificity was 100%,65.2%,68% and 65.3% respectively;the positive predictive value was 100%,68.1%,71%,75.4% respectively;the negative predictive value was 100%,60.3%,57.2%,78.3% respectively.The Youden index （correct index） was 1.0,0.24,0.29,0.38 respectively.Diagnostic tests RSR analysis showed the RSR value of SWI,T2WI,T1WI and DWI was 1.0,0.3,0.5,0.7 respectively.Conclusion：SWI was superior to conventional MRI sequences in the diagnosis of cerebral post-infarct hemorrhage,and can be used as the routine examination for patients with acute cerebral infarction and follow-up after thrombolytic therapy.