多序列磁共振技术在急性脑梗死早期诊断中的价值分析

The Value of Multisequence MRI Techniques in the Early Diagnosis of Acute Cerebral Infarction

目的探讨磁共振多种技术(包括常规MRI、DWI、MRA、PWI、MRS),分析急性脑梗死在MRI不同序列的成像特征,并评估这些技术对急性脑梗死的早期诊断价值。方法对发病48h以内的48例急性脑梗死患者行磁共振多序列扫描,包括T1WI、T2WI、DWI、MRA、PWI、MRS等序列,并对所得图像进行后处理和分析。结果 48例患者发病后就诊DWI能全部发现病灶,T2WI在24h内部分发现病灶,48h内全部发现病灶。梗死灶大于15mm的患者MRA发现脑动脉异常的比率高于梗死灶小于15mm的患者。急性脑梗死患者梗死区PWI血流灌注少于对侧正常区,且MRS显示梗死区NAA不同程度下降,还可见不同程度Lac峰。结论多序列磁共振技术可以在急性期、甚至超急性期显示脑梗死灶,显示病灶周围缺血半暗带,对患者选择有效的治疗方案和判断预后具有重要意义。

Objective To analyze the features of various magnetic resonance image sequences in acute cerebral infarction by using multiple MRI techniques （conventional MRI, DWI, MRA,PWI and MRS） ,and to evaluate the value of these MRI techniques in the early diagnosis of acute cerebral infarction. Methods Cranial MRI including TIWI,T2WI, DWI, PWI, MRA and 1H - MRS was performed in 48 acute cerebral infarction patients within 48 hours after the onset of stoke symptoms. Eventually, the obtained MR pictures were carried on the post - processing and analysis. Results DWI could show high signal in all patients. T2WI could show a part of focus in 24 hours but can show all in 48 hours. MRA found higher ratio of cerebral artery anomalies in patients with infarcts more than 15mm than patients with infarcts less than 15mm. Infarcted PWI perfusion in patients with acute cerebral infarction was less than the normal contralateral, and MRS showed decreased NAA peak to different extent, and still visible Lac peak. Conclusion Muhisequence MRI techniques in the acute phase, even super acute brain infarcts can show the focus and display surrounding tissue, which is important for patients to choose effectire treatment and predict prognosis.