脑内血肿的高场强MRI特征分析

High-field MRI findings of intracerebral hematoma

目的分析脑内各期血肿的高场强MRI表现,提高对脑内血肿的诊断准确率。方法 37例脑内血肿患者均经临床结合GE 1.5 T Signa MRI或/和CT检查确诊并对血肿进行分期,其中超急性期4例,急性期10例,亚急性期17例,慢性期6例。结果 4例超急性期血肿T1WI等信号,T2WI稍高信号,DWI高信号;10例急性期血肿T1W等信号,T2WI低信号,DWI低信号;7例亚急性早期T1WI外周环状高信号,中心等信号,T2WI仍呈稍低信号,DWI呈低信号;10例亚急性晚期T1WI、T2WI均呈较均匀高信号,DWI呈高信号;6例慢性期血肿由T1WI、T2WI高信号逐渐演变为呈长T1长T2信号的液化灶。结论脑内血肿超急性期、急性期、亚急性各期及慢性期MRI表现较具特征性。MRI能较好反应脑内血肿各期血肿成份的演变过程,在与其它占位效应的病变鉴别中具有重要价值。

Objective To investigate the accuracy of MRI in intracerebral hematoma by analyzing high-field MRI findings of intracerebral hematoma in different stages.Methods MRI data of 37 cases with intracerebral hematoma was retrospective analyzed,including 4 cases in superacute stage,10 cases in acute stage,17 cases in subacute stage,and 6 cases in chronic stage.All patients underwent MRI examination with 1.5-Tesla MRI scanner（Signa,GE） and were confirmed by clinic.Results Four cases of superacute intracerebral hematoma demonstrated iso-intensive signal on T1W,slightly hyper-intensive signal on T2W,and high-intensive signal on DWI.Ten cases of acute intracerebral hematoma manifested iso-intensive signal on T1W,low-intensive signal on T2W,and low-intensive signal on DWI.Seven cases of early sub-acute intracerebral hematoma showed high-intensive signal in brim and iso-intensive signal in center on T1W,slightly low-intensive signal on T2W,and low-intensive signal on DWI.Ten cases of lately sub-acute intracerebral hematoma represented symmetrically high-intensive signal on T1W,T2W,and DWI.Six cases of chronic intracerebral hematoma gradually evolved into liquefaction foci represented as long-T1 and long-T2 signals.Conclusions Intracerebral hematoma in superacute,acute,subacute,and chronic stages own respectively characteristic MRI findings.MRI is a preferable imaging method that could commendably reflect the evolvement process of intracerebral hematoma,and can differentiate hematoma from other intracranial space occupying lesions.