脑微出血的T_2*WI成像的临床分析

Clinical analysis on cerebral microbleeds in T_2* WI imaging

目的通过分析脑微出血（CMBs）T2＊WI序列图像和临床资料相关性,探讨T2＊WI序列扫描对CMBs病变的临床应用价值,尤其是对临床症状不典型的CMBs患者的应用价值。方法结合临床资料回顾性分析2009年1月—2010年3月收治的18例查体均无阳性神经系统病理征的CMBs患者的MRI T2＊WI序列图像。结果 MRI平扫表现为单纯性脑萎缩2例、脑白质缺血改变5例,合并有脑白质缺血改变与腔隙性脑梗死4例,合并有脑萎缩、脑白质缺血改变和腔隙性脑梗死7例。有2例患者于丘脑区于T2＊WI序列见1~2个大小约3 mm低信号影。T2＊WI序列扫描见CMBs灶的部位位于双侧基底节区、单侧丘脑、单侧小脑半球各有6例,出血灶数量为多灶性出血,多的表现为＂满天星＂样,最少的出血灶为4个,出血灶的大小约2~5 mm,相应部位有腔隙性脑梗死灶。结论在患者临床症状不典型,但年龄比较大、有高血压病史、MRI平扫有脑白质缺血改变、腔隙性脑梗死表现时应增加T2＊WI序列扫描,可以发现CMBs,从而减低在CMBs基础上发生后果更严重脑损伤的可能性。

Objective To analyze the brain micro-blood（CMBs） T2＊ WI sequence of images and correlation of clinical data,and explore the clinical value of T2＊ WI sequence in scanning CMBs lesions,especially for the application value of untypical clinical symptoms of patients with CMBs.Methods Retrospective analyzed the MRI T2＊ WI sequence of images and clinical data of 18 patients with CMBs who had admitted to hospital in January 2009 to March 2010,physical examination there was no positive pathological neurological signs.Results MRI scanning showed that brain atrophy in 2 cases,leukoencephalopathy in 5 cases,leukoencephalopathy syndrome with lacunar infarction in 4 cases,brain atrophy syndrome with leukoencephalopathy and lacunar infarction in 7 cases,one or two about 3mm low signal intensity in T2＊ WI were demonstrated in 2cases＇thalamus.T2＊ WI scanning showed that CMBs located in bilateral basal ganglia lesions,unilateral thalamus and cerebellar hemisphere each of 6 cases,the number of hemorrhage is multifocal hemorrhage more,characterized by star-filled.At least the bleeding lesions were only 4 cases,bleeding lesions the size of the hemorrhage about 2-5mm.There was lacunar infarction in corresponding parts.Conclusion T2＊ WI scanning should be increase when patients had untypical clinical symptoms,elderly age,history of hypertension and MRI scanning showed Leukoencephalopathy and lacunar infarction.It can discover CMBs thus reducing the chance of more serious brain injury based on micro-bleeding in the brain.