高敏感SWAN序列诊断自发性蛛网膜下腔出血的价值

The value of the SWAN sequence in the diagnosis of spontaneous subarachnoid hemorrhage

目的 :探讨SWAN序列对自发性蛛网膜下腔出血(subarachnoid hemorrhage,SAH)及合并脑室内积血(intraventricular hemorrhage,IVH)的诊断价值。方法 :回顾性分析自发性SAH患者32例,均行CT平扫及MRI T1WI、T2WI、FLAIR、SWAN、DWI检查,分析CT平扫与MRI各序列对各期SAH和IVH的检出率。结果:1急性期:CT平扫、FLAIR序列、SWAN对SAH的诊断敏感度均较高,三者差异无统计学意义,但与MRI其他序列相比,差异有统计学意义(P=0.031)。2亚急性期:T1WI、FLAIR、SWAN对SAH的诊断敏感度优于CT和MR其他序列,差异有统计学意义(P<0.05)。3慢性期:MRI各序列对于SAH的诊断敏感度均明显优于CT,尤其是SWAN序列(P=0.008)。4对SAH合并IVH的检出,急性期CT与SWAN、DWI(b=0 s/mm^2)的检出能力相当,较MRI其他序列强;且亚急性期和慢性期SWAN、DWI(b=0 s/mm^2)的检出能力明显优于CT。结论:SWAN序列对各期SAH的诊断敏感度较CT及MRI其它序列有优势,SWAN、DWI(b=0 s/mm^2)对于SAH合并IVH的检出也有优势,SWAN是目前检出少量SAH及IVH最好的检查方法。

Objective：To study the value of SWAN sequence in the diagnoses of spontaneous subarachnoid hemorrhage and the combination of intraventricular hemorrhage. Methods：Select 32 cases of SAH patients who underwent MRI and CT scan,to compare displayed difference of CT and magnetic resonance for each phase of SAH and IVH. Results： ①In acute phase,the diagnosis sensitivity of SAH was higher on CT,FLAIR,SWA]N,but there had no statistical significance between them. There had statistical significance between them and other MR sequences. ②In sub-acute phase,the diagnosis sensitivity on T1WI,FLAIR, SWAN was higher than CT and other MR sequences,and there was significant difference between them （〈0.05）. ③In chronic phase,the diagnosis sensitivity on all sequences of MRI were higher than CT,especially SWAN （P=0.008）. ④In acute phase,the detection of intraventricular hemorrhage among CT,SWAN and DWI （b=0 s/mm^2） was similar,and higher than other MR sequences for IVH. In sub-acute phase and chronic phase,the detection of intraventricular hemorrhage of SWAN,DWI （b=0 s/mm^2） was better than CT. Conclusion：①The SWAN is better than CT and other MR sequences to detect SAH in each phase. ②DWI（b=0 s/mm^2） sequence is similar sensitive as SWAN to detect IVH. SWAN is the best method to detect the small amount of SAH and IVH.