磁敏感加权成像在急性缺血性脑梗死诊疗中的临床价值

The Clinical Value of Susceptibility-weighted Imaging in Diagnoisis and Treatment of Acute Ischemic Cerebral Infarction

目的:探讨磁敏感加权成像(SWI)在急性缺血性脑梗死诊疗中的临床价值。方法:对36例急性脑梗死患者进行CT、常规MRI、MRA、DWI及SWI的检查,对影像学进行对比研究。结果:36例脑梗死病灶在DWI图像上均显示高信号;MRA上31例可见大脑前、中、后动脉有不同程度狭窄、闭塞或分支血管减少,1例显示颈内动脉有闭塞;SWI上24例发现梗死区静脉血管减少,7例静脉血管缺失,13例SWI上发现不同程度的脑出血,而CT及常规MRI仅4例显示明确脑出血。结论:SWI对显示脑梗死合并脑微出血有特异性表现,且有评价梗死区脑组织存活性的潜在价值;SWI在急性脑梗死的诊断和临床治疗中起着重要作用,可列为急性脑梗死的检查常规。

Objective To explore the clinical value of MR susceptibility-weighted imaging（SWI） in diagnosis and treatment of acute ischemic cerebral infarction.Methods 36 cases with acute ischemic cerebral infarction were performed with computer tomography（CT）,conventional MRI,magnetic resonance angiography（MRA）,diffusion weighted imaging（DWI） and SWI.All the images were analyzed comparatively.Results 36 cases cerebral infarction were demonstrated by high signal on DWI images.MRA manifested the stenosis,obliteration or reduction in branch of anterior cerebral artery,middle cerebral artery and posterior cerebral artery in 31 cases.The occlusion of internal carotid artery was demonstrated in 1 case.SWI showed Veins in the area of infarction reduced in 24 cases,absence in 7 cases and varying degrees cerebral hemorrhage in 13 cases,but on CT and routine MRI only 4 cases showed hemorrhage clear and definite.Conclusions SWI can manifest the specificity in acute cerebral infarction complicating brain microbleeds,and can be used to estimate the activity of brain tissue of infarction area,which significantly influence the decision of clinic treatment.Therefore SWI should be a routine examination for the diagnosis of acute cerebral infarction.