MRI和CT两种不同影像学检查方法对早期腔隙性脑梗塞的临床诊断价值分析

MRI and CT for diagnosis of early lacunar infarction

目的探讨MRI和CT两种不同影像学对早期腔隙性脑梗塞的临床诊断价值。方法回顾分析我院2012年3月至2015年6月收治已确诊早期腔隙性脑梗塞并均已经行CT、MRI检查的患者共326例，分析所有患者ET及MRI的诊断结果，对比两种检查方式的病灶检出率，比较患者对两种检查方式所用时间、花费情况的满意度。结果本次研究共回顾326例早期腔隙性脑梗塞患者，经整理筛除7例图像得不到专家一致诊断意见的病例。余下319例患者中，行CT平扫后发现268处病灶，病灶大小约0．5～1cm左右；行MRI检测发现病灶472处，其中病灶多小于0．5cm，两者差异有统计学意义（P〈0．05）。319例患者中有231例对MRI比较满意，满意度为72．4％；有235例患者对CT比较满意，满意度为73．7％；两者差异无统计学意义（P〉0．05）。结论对早期腔隙性脑梗塞患者的临床诊断，MRI要比CT更为敏感，且不具有辐射，安全系数较CT更高。但是319例患者对CT的满意度略高于MRI，除了因为MRI耗时需十多分钟、部分心肺功能衰竭患者不能耐受以外，更主要的因素还是MRI费用要比CT高得多，可见低收费与高检出率在患者心中均占有较大比例，进一步增强CT敏感度、降低MRI的消耗成本是接下来我们工作的重点。

Objective To investigate the clinical diagnostic value of MRI and CT in early lacunar infarction. Methods Clinical data of 326 cases of early lacunar infarction underwent CT, MRI examination in our hospital from March 2012 to June 2015 was retrospectively analyzed. Analyzed the diagnosis of all patients by CT and MRI, compared lesion detection rate of two methods, satisfaction on examination time and cost. Results The study reviewed 326 cases of early lacunar infarction, excluding 7 cases on whose image views of experts were not consistent. In other 319 cases, 268 lesions were found after plain CT scan, with lesion size about 0.5-1 cm; 472 lesions were found after MRI examination, whose size were mostly less than 0.5 cm; there was statistically significant difference between two examination methods （P〈0.05）. In 319 cases, 231 cases were quite satisfied with MRI, with the satisfaction degree of 72.4%; 235 cases were quite satisfied with CT, with the satisfaction degree of 73.7%; there was no statistically significant difference between two examination methods （P〉0.05）. Conclusions In clinical diagnosis of early lacunar infarction patients, MR1 is more sensitive than CT, without radiation, with a higher safety factor. But the satisfaction degree on CT of 319 cases is slightly higher than that on MRI, in addition to MRI taking more than ten minutes, some heart and lung failure patients can not tolerate MRI, the main factor is that cost of MRI is much higher than that of CT, showing low-cost and high detection rate account for a large proportion in the heart of patients. Enhancing the sensitivity of CT and reducing the cost of MRI are the next focus of our work.