DWI结合flair对脑梗塞分期的诊断价值

Value of DWI in periodization of cerebral infarction

目的探讨MR弥散加权成像（DWI）结合flair对脑梗塞（Cerebral infarction）分期的价值。方法回顾分析2007年1月～2013年9月578例资料完整的脑梗塞病例,计算MRI各序列对超急性期、急性期、慢性期脑梗塞诊断的阳性率。结果对超急性期〈6小时及慢性期≥11天脑梗塞,DWI序列及DWI结合flair的检出率均明显比T1WI、T2WI、Flair序列高,其检出率差异有统计学意义（P〈0.05）,对急性期（＞6小时～10天以内）脑梗塞,T1WI、T2WI、Flair序列的检出率与DWI序列的检出率差异无统计学意义（P＞0.05）,单一序列影像诊断与临床符合率最高的是DWI,而DWI结合flair得出的诊断与临床符合率更高。结论 DWI结合flair是脑梗塞分期的重要手段,为提高诊断的准确性,对脑梗塞不能只作常规的T1WI和T2WI,还应加作flair、DWI,这对鉴别新、旧脑梗塞尤其重要。

Objective To discuss the value of DWI combined with flair for cerebral infarction staging.Methods 578 patients with cerebral infarction were analyzed.The positive rate of MRI diagnosis of each sequence to hyperacute,acute and chronic phase cerebral infarction were observed.Results The detection rate of DWI and DWI combined with flair sequence was significantly higher than that of T1WI and T2WI.Flair sequence for Hyperacute phase（6hor less）and chronic（11days and beyond）infarction and detection rate were significantly difference（P〈0.05）.The detection rate between DWI sequences and T1WI,T2WI,flair sequences were not statistically significant for acute phase（6h-10dless）infarction（P〉0.05）.The highest rates of single imaging sequence of infarction diagnosis in accord to clinical were DWI.However,DWI combined with flair sequence had higher compliance rate compared with clinical diagnosis.Conclusion DWI combined with flair is an important method of staging of cerebral infarction.To improve the accuracy of diagnosis of Cerebral infarction,we should not only take conventional T1WI and T2WI but also take flair and DWI examination.This is particularly important for the identification of new and old cerebral infarction.