3.0T磁共振磁敏感加权成像对出血性脑梗死的诊断和鉴别诊断价值

The diagnostic and differential diagnostic value of MR susceptibility weighted imaging in the hemorrhagic cerebral infarction

目的探讨3.0T磁共振磁敏感加权成像(SWI)对出血性脑梗死的诊断和鉴别诊断价值。方法对430例脑梗死患者行MR的T1WI、T2WI、DWI与SWI扫描,分析T1WI、T2WI、DWI和SWI对出血性脑梗死检出率的差异和SWI对于出血性脑梗死的鉴别诊断价值。结果 SWI检出出血性脑梗死45例,T1WI检出20例,T2WI检出28例,DWI检出31例。结论 SWI较MR常规序列(T1WI和T2WI)和DWI序列可检出更多的出血性脑梗死病例;可早期发现脑梗死中的出血灶,明显优于MR常规序列(T1WI和T2WI)和DWI序列;具有一定的鉴别诊断价值;可作为出血性脑梗死检查的一线方法或常规序列。

Objective To explore the clinical application value of susceptibility weighted imaging （SWI） in hemorrhagic cerebral infarction. Methods 430 cases of cerebral infarction in our hospital were enrolled. All patients were performed at 3.0T MRI scanner （Achieva; Philips Medical Systems, the Netherlands） in axial planes of conventional sequences （T1WI and T2W1）, DW1 and SWI. The presence or absence of hemorrhagic lesions were analyzed on T1WI, T2WI, DWI and SWI images. The differential diagnosis of hemorrhage in the cerebral infarction was analyzed using SWI. Results Of all patients, hemorrhagic cerebral infarction were diagnosed in 45 cases by SWI sequence, 20 cases by T1WI, 28 cases by T2WI and 31 cases by DWI. Conclusion Compared with MR conventional imaging （T1WI and T2WI） and DWI imaging, SWI can be able to detect more hemorrhagic lesions in earlier stage. SWI is superior to MR conventional imaging （T1WI and T2 WI） and DWI imaging in the diagnosing hemorrhagic cerebral infarction, and then can be used as the first line, routine and follow-up examination for patients with acute cerebral infarction.