SWI在颅脑疾病中的诊断价值

The Value of SWI in Brain Diseases

目的探讨磁敏感加权成像(SWI)作为常规序列在颅脑磁共振检查中的应用价值。材料与方法对我院2012年10月-2013年2月1354例初次头颅MRI检查的患者均行常规序列及SWI扫描,并分为低(0-30岁,98例)、中(31-60岁,472例)、高(60岁以上,784例)三个年龄组。计算各序列显示病灶的数目,比较T1WI、T2WI、T2FLAIR与SWI序列对病灶检出率的差异。结果 1354例中有287例患者SWI序列出现低信号病灶,阳性率21.2%,95例在常规序列常规显示相应病灶,阳性率7.0%,两者存在统计学差异(X2=95.6,P<0.01)。低龄组中SWI检出6例有低信号灶,检出率为6.1%;中龄组69例,检出率为41.6%;高龄组212例,检出率为27.1%;三者检出率间存在显著统计学差异(X2=84.4,P<0.01)。T1WI对病灶显示都不明显、T2WI检显示低信号灶367个、T2FLAIR显示低信号病灶721个,SWI序列显示低信号2851个。结论①SWI对于脑内微量出血、血液代谢物及静脉结构等低信号灶的检出有较常规序列明显高的敏感性,在头颅MRI检查中SWI作为常规扫描序列推广应用具有重要的临床价值;②颅内SWI病灶的检出率与年龄相关。

Objective To analyze the clinical value of susceptibility weighted imaging（SW1） as a conventional sequence in craniocerebral MRI examination. Material and Methods Totally 1354 patients with brain MRI examination were performed with both 8WI and conventional MR1 sequences at 3.0T MR, and divided into low age group （ 0-30 yeas old n=98 ） , middle age group （31-60 yeas old n=472 ） , senile group （〉60 yeas old n=784 ） . Calculated the number of lesions on SWI and conventional sequences and compared the detection rate of lesions between conventional T1WI,T2WI,T2FLAIR, sequences and SWI. Results The number of patients with low signal lesions were 287 detected by SWI image, detection rate was 21.2%. 95 patients with low signal lesions were detected by conventional sequences, the detection rate was7.0%. There was a significant difference between the detection rates （X^2=95.6 P〈0.01 ） . The detection rate of low age group , middle age group and senile group were 6.1%（n=6）,41.6% （ n=69 ） and 27. 1% （ n=212 ） respectiveIy. There was significant difference between the detection rates （ X^2=84.4 P〈0.01 ） . Lesions were not revealed on TIWI image. The number of low signal lesions were 367 detected by T2WI image, 721 detected by T2 FIAIR） and 2851 detected by susceptibility weighted imaging respectively. Conclusion .① SWI is more sensitive to low-flow vascusar malformation, small venous structures, multiple small bleeding and calcium deposition of iron than conventional sequences. SWI as a regular scan sequence has important clinical value in craniocerebral MRI examination.② The detection rate of lesions on SWI is related to the ages.