磁敏感加权成像在脑内微出血影像诊断中的价值

Clinical application of MR susceptibility weighted imaging in the diagnosis of cerebral micro-bleedings

目的:探讨磁敏感加权成像(SWI)在脑微出血(CMBs)影像诊断中的价值。方法:对232例拟诊脑血管病患者行常规MR头颅平扫T2WI、T2FLAIR、T1WI、DWI序列及SWI序列,对常规序列显示的CMBs数目、敏感性与SWI序列比较并进行统计学处理。结果:28例有脑内微出血,SWI序列共检出CMBs 186个,T2WI序列共检出CMBs 38个,CMBs病灶检出敏感性为20.4%;T1WI序列共检出CMBs 21个,CMBs病灶检出敏感性为11.3%。T2FLAIR共检出CMBs 41个,CMBs病灶检出敏感性为22%,DWI序列共检出CMBs 24个,CMBs病灶检出敏感性为12.9%,多序列CMBs检出数目比较,差异有统计学意义(P<0.05);SWI序列与T1WI、T2WI、T2FLAIR、DWI序列CMBs检出敏感性比较,差异具有统计学意义(P<0.05);28例中,22例有高血压病史,同时合并出血性卒中患者14例,缺血性卒中患者8例,混合性卒中患者6例。结论:SWI序列对CMBs的检出敏感性高于常规序列,CMBs病灶的检出可以反映脑内微血管病变程度,对脑卒中的治疗及预后判断具有较为重要的临床应用价值。

Objective：To explore the diagnostic value of MR susceptibility weighted imaging（SWI） in the cerebral micro-bleedings（CMBs）,as well as its application in the treatment of cerebral infarction.Methods：Conventional MR sequences including T1WI,T2WI,T2FLAIR and DWI sequences were performed in 232 patients as well as SWI sequence.The numbers of CMB and sensitivity of positive rate on SWI and conventional sequences were compared and statistically analyzed.Results：28 cases had the cerebral CMBs with a total of 186 CMB lesions on SWI,38 CMBs were detected on T2WI,and the sensitivity was 20.4%.21 CMBs were detected on T1WI,and the sensitivity was 11.3%.41 CMBs were detected on T2FLAIR,and the sensitivity was 22%.24 CMBs were detected on DWI,and the sensitivity was 12.0%.There was statistic difference in showing micro hemorrhagic lesions among those sequences,P0.05.CMBs were detected on SWI,and the sensitivity was 100%.SWI was more sensitive than other sequences in showing micro hemorrhagic lesions,P0.05.Of 28 cases,22 had the history of hypertension,and 14 had hemorrhagic stroke,8 had ischemic stroke,and 5 had with both ischemic and hemorrhagic stroke.1 patient happen found the CMB by check-up.Conclusion：SWI has predominant advantage over conventional MRI sequences in detecting CMBs.Detection of CMBs can reflect cerebral micro-vessel disease.SWI provides important reference for the treatment and evaluating prognosis of cerebral infarction.