急性缺血性卒中合并脑微出血患者磁敏感成像的影像学特征观察

Imaging features of susceptibility weighted imaging in patients with acute ischemic strokes and cerebral microbleeds

目的观察急性缺血性卒中合并脑微出血患者磁敏感成像的影像学特征。方法回顾性分析2014年7月~2015年6月本院收治的73例急性缺性卒中患者,按照患者是否合并脑微出血分为以下两组:急性缺血性卒中合并脑微出血作为试验组(42例),未合并脑微出血的急性缺血性卒中患者为对照组(31例)。均给予所有普通磁共振和磁敏感成像检查,对两种检查方式在诊断急性缺血性卒中合并脑微出血患者中的价值进行比较分析,观察比较两组患者的有关危险因素。结果急性缺血性卒中合并脑微出血患者经磁敏感成像的检出率100.00%(42/42)高于普通磁共振检出率69.05%(29/42),患者经普通磁共振成像检查后,其出血面积为(723.42±76.34)mm^2明显小于磁敏感成像的检查面积(988.21±82.11)mm^2,组间比较差异性明显(P<0.05)。两组患者在舒张压、收缩压、脑白质变性级别及腔隙性脑梗死级别方面存在明显差异(P<0.05)。结论急性缺血性卒中合并脑微出血患者经磁敏感成像检查,可清晰观察到脑微出血,具有较高的诊断率,因此,在预防和治疗脑微出血患者中具有重要的临床意义。

Objective To explore the imaging features of susceptibility weighted imaging（SWI） in patients with acute ischemic strokes and cerebral microbleeds（CMBs）. Methods 73 patients with acute ischemic strokes who were in our hospital from July 2014 to June 2015 were divided into two groups according to the CMBs situations： 42 patients with acute ischemic strokes and CMBs were assigned to experimental group, 31 acute ischemic stroke patients without CMBs were assigned to control group. All patients received common magnetic resonance imaging（MRI） and SWI examinations, the diagnosis values of the two methods for patients with acute ischemic strokes and CMBs were compared, the related risk factors for patients in the two groups were compared. Results The detection rate of SWI examination in the patients with acute ischemic stroke and CMBs was 100.00%（42/42）, which was higher than the 69.05%（29/42） of MRI, the patients＇ bleeding areas on MRI pictures were（723.42±76.34） mm^2, which were obviously smaller than the（988.21±82.11） mm^2 of SWI, the differences were statistically significant（P〈0.05）. The differences of diastolic pressure, systolic pressure, myelinopathy grades and lacunar infarction grades between the two groups were statistically significant（P〈0.05）. Conclusion The CMBs lesions can be clearly observed on the SWI pictures of patients with acute ischemic strokes and CMBs. The SWI examination has a high detection rate and important clinical significance in the prevention and treatment of CMBs in patients.