磁共振弥散加权成像和3D-时飞法血管成像诊断超急性期大面积脑梗死83例

The value of MRI DWI combined with 3D-TOF MRA in the diagnosis of hyperacute massive cerebral infarction in 83 cases

目的:探讨磁共振(MRI)弥散加权成像(DWI)和3D-时飞法(3D-TOF)血管成像(MRA)联合检查在超急性期大面积脑梗死中应用价值。方法:83例超急性期脑梗死病例均行常规MRI、DWI序列及3D-TOF MRA扫描,并根据MRI不同序列对病变进行比较。结果:发病时间<2 h的51例和发病时间2～6 h的13例T1WI和T2WI均为正常,发病时间2～6 h的19例T2WI呈稍高信号影。DWI全部显示为高信号。3D-TOF MRA显示动脉狭窄和闭塞78例,其中颈内动脉闭塞7例;大脑中动脉分支闭塞19例;大脑后动脉闭塞10例。结论:DWI可以明确诊断急性期脑梗死及其发病部位,结合3D-TOF技术MRA可快速而准确地显示颅内动脉狭窄或闭塞及其相应的脑梗死。

Objective： To investigate the clinical value of MRI diffusion weighted imaging（DWI） combined with 3D-TOF magnetic resonance angiography（MRA） in the diagnosis of hyperacute massive cerebral infarction.Methods： Eighty-three cases with acute cerebral infarction were scanned using conventional MRI,DWI sequence and 3D-TOF MRA,the lesions in different sequence MRI were compared and analyzed.Results： The T1WI and T2WI of 51 cases with onset time less than 2 h and 13 cases with onset time between 2-6 h were normal.The T2WI of 19 cases with onset time between 2-6 h were slightly high signal.All DWI were high signal.The artery stenosis and occlusion in 78 cases were found by 3D-TOF MRA,which included 7 cases of internal carotid artery occlusion,19 cases of middle cerebral artery occlusion and 10 cases of posterior cerebral artery occlusion.Conclusions： DWI can diagnose acute cerebral infarction and identify its location.DWI combined with 3D-TOF MRA technology can quickly and accurately show the intracranial artery stenosis or occlusion and corresponding cerebral infarction.