不同期别脑出血MRI诊断及信号变化特点

MRI diagnosis for all phase cerebral hemorrhage and analysis characteristics of signal evolution

目的 探讨各期脑出血MRI诊断及信号演变特征,以提高对本病的诊断水平。方法 分析临床确诊的65例脑出血患者MRI影像资料。结果 65例中,超急性早期（6h内）3例,T1WI为等信号,T2WI为等信号,T2Flair为稍低信号,DWI为低信号,周围无水肿;超急性晚期（6~24h）7例,T1WI为稍低信号,T2WI为稍高信号,T2Flair为稍低信号,DWI为低信号,周围轻度水肿;急性期（1~3d）8例,T1WI为等信号,T2WI为低信号,T2Flair为极低信号,DWI为极低信号,周围中度水肿;亚急性早期（4~7d）7例,T1WI为外高中低信号,T2WI为低信号,T2Flair为低信号,DWI为低信号,周围重度水肿;亚急性中期（8~15d）11例,T1WI为高信号,T2WI为外高中低信号,T2Flair为外高中低信号,DWI为外高中低信号,周围中度水肿;亚急性晚期（16~30d）7例,T1WI为高信号,T2WI为高信号,T2Flair为高信号,DWI为高信号,周围轻微水肿;慢性期（1~2个月）7例,T1WI为高信号,T2WI为高信号,周围有黑环,T2Flair为高信号,周围有黑环,DWI为高信号,周围有黑环,病变周围无水肿;残腔期（3个月以上）15例,T1WI为低信号,T2WI为高信号,周围有黑环,T2Flair为低信号,DWI为低信号,病变周围无水肿。结论 不同期别脑出血的MRI表现具有特征性,超急性期、急性期出血在T2Flair、DWI均表现为低信号,而亚急性期出血在T1WI表现为高信号,慢性期、残腔期T2WI病变周围有低信号环为特点。

Objective To study MRI diagnosis for all phase cerebral hemorrhage and analysis characteristics of signal evolution, and to improve imaging diagnostic accuracy of its. Methods In the 65 cases of cerebral hemorrhage proved by clinical diagnosis were analyzed in MRI imaging. Results Among the 65 cases, 3 cases were super acute early （6 h）, TIWI is equal signal, T2WI such as, T2 Flair is slightly low signal, DWI is low signa, no edema around;7 cases were super acute late （6-24h）, T1WI is slightly low signal, T2WI is slightly high signal, T2 Flair is slightly low signal, DWI is low signa, mild edema around;8 cases were acute period （ 1-3d）, T1WI is equal signal,T2WI is low signal, Tz Flair is extremely low signal, DWI is extremely low signal, moderate edema around. Early subacute（4-Td） in 7 cases, T1WI is outside high inside low signal, T2WI is low signal, T： Flair is low signal, DWI is low signal, severe edema around; Mid subacute （8-15d） in 11 cases, TI WI is high signal, T2WI is outside high inside low signal, T2 Flair and DWI is too, moderate edema around. Subacute late （16-30d） in 7 cases,TiWI is high signal,T2WI,T2 Flair and DWI is too,mild edema around. Chronic phase （1-2month） in 7 cases,T1WI is high signal,T2WI,T2 Flair and DWI is high signal, surrounded by black ring, no edema around the lesion. Residual cavity （more than 3 m） in 15 cases,T1WI is low signal,T2WI is high signal,surrounded by black ring,T2 Flair and DWI is low signal, can no edema around the lesion. Conclusion Have characteristic MRI manifestation for different period cerebral hemorrhage, super acute and acute period hemorrhage is low signal in T2 Flair and DWI, subacute is high signal in TzWI,chronic phase and residual cavity lesions around low signal ring in T2WI.