SWI评估高血压程度与脑内微出血相关性的研究

Study on the relationship between cerebral micorbleeds and severity of hypertension assessed by ssceptibilityweighted imaging

目的探讨磁敏感加权成像(SWI)对脑内微出血(CMBs)的诊断价值,以及高血压程度与CMBs相关性,为临床诊治提供参考。方法回顾性分析台州市第一人民医院神经内科收治的150例高血压合并CMBs患者的常规磁共振成像(MRI)及SWI资料,依据CMBs所在的部位(即皮质-皮质下区、基底核、丘脑、脑干、小脑)确定CBMs的位置,并计算各部位CMBs的数量,同时分析CMBs的数量与高血压程度、持续时间及血压控制情况的相关性。结果 150例患者均有CMBs的存在,多呈类圆形、均匀的极低信号区,边界较为清楚,多表现为孤立性,共检出CMBs病灶526个,以多发为主,且主要分布于基底核(35.6%)、丘脑(30.8%)等深部区域。在不同高血压分级、高血压持续时间及高血压控制情况的患者中,平均CMBs的数量比较差异具有统计学意义(P<0.05);CMBs的级别与腔隙性脑梗死的级别之间存在显著的正相关(r=0.269,P=0.0009)。结论 SWI对CMBs具有较高的敏感性,可明显提高CMBs的检出率,且CMBs的数量与高血压程度呈明显的正相关,对高血压合并CMBs患者进行严格的血压控制,可有效减少CMBs的形成,阻止小血管破坏的进展。

Objective To explore the diagnosis value of susceptibility-weighted imaging（SWI） for cerebral micorbleeds （CMBs）, and study the relationship between cerebral micorbleeds and severity of hypertension assessed by SWI,in order to provides the reference for clinician. Methods Clinical data on routine MRI and SWI of 150 patients with hypertension combined with CMBs in the department of neurology in our hospital was retrospectively analyzed. The number of CMBs was calculated hy the position of the CBMs according the different parts of CMBs （ cortex-subcortical area, basal ganglia, thalamus, brain stem, cerebellum）. And the association of numbers of CMBs with severity of hypertension, time of duration and control of blood pressure were analyzed. Results All the 150 cases have the existence of CMBs, round, symmetrical extremely low signal area, the boundary was more clear for isolated existence. A total of 526 CMBs was detected, mainly multiple, and mainly distributed in the deep areas such as basal ganglia（ 35.6% ）, thalamus （30.8%）. There was signifi- cant difference on the number of CMBs among the severity of hypertension, time of duration and control of blood pressure （P 〈 O. 05）. The grade of CMBs had significant positive correlation with grade of lacunar infarction （ r = 0. 269, P = 0. 0009）. Conclusion SWI had high sensitivity to CMBs,it can obviously improve the CMBs detection, and the number of CMBs was obviously positive correlated with severity of hypertension. Strict blood pressure control in patients with hy- pertension combined CMBs, which can effectively reduce the formation of CMBs, stop the progress of the small blood ves- sel damage.