3.0T磁敏感加权成像在诊断出血性脑梗死中的临床应用

Clinical Application of 3.0T SWI in Diagnosis of Hemorrhagic Cerebral Infarction

目的探讨磁敏感加权成像(SWI)对出血性脑梗死的临床诊断价值。方法对40例出血性脑梗死患者分别行常规MRI、弥散加权成像(DWI)及SWI扫描,比较不同序列对出血性脑梗死的检出率及出血灶数量的显示情况;观察SWI序列对脑梗死灶及周围区域微出血灶的显示情况,以及脑梗死灶内静脉血管的改变。结果 SWI序列对出血性脑梗死的检出率及出血灶数量的显示均明显优于DWI序列及常规MRI序列(χ2=37.5,χ2=51.82,P值均<0.05)。40例患者中,14例患者在脑梗死区域外发现微出血灶,26例脑梗死灶内小静脉血管分支明显减少,13例血管明显增多。结论 SWI诊断出血性脑梗死的阳性率明显优于常规MRI序列及DWI序列,可作为出血性脑梗死检查的首选或常规序列。

Objective To investigate the effectiveness of SWI（Susceptibility Weighted Imaging） in diagnosis of hemorrhagic cerebral infarction. Methods Altogether 40 cases of hemorrhagic cerebral infarction patients underwent routine MRI（Magnetic Resonance Imaging）, DWI（Diffusion Weighted Imaging） and SWI scanning so as to compare the detection rate of hemorrhagic cerebral infarction and display of the number of hemorrhage lesions. Additionally, the influence of different SWI sequences on demonstration of cerebral infarction lesions and surrounding micro-hemorrhagic lesions as well as intravenous changes in cerebral infarction lesions were observed. Results The SWI sequence demonstrated its superiority over DWI sequences and conventional MRI sequences in the detection rate of hemorrhagic cerebral infarction and display of the number of hemorrhage lesions（respectively χ2=37.5, χ2=51.82, P〈0.05）. Among 40 cases, micro-hemorrhage was seen outside the cerebral infarction region in 14 patients; small intravenous branches decreased markedly in 26 cases; veins obviously increased in 13 cases. Conclusion SWI showed superiority over conventional MRI and DWI sequences in positive detection rate of of hemorrhagic cerebral infarction, which could be taken as the first-choice examination method for hemorrhagic infarction.