磁共振成像-T_2液体衰减反转恢复序列成像高信号血管征在急性大脑中动脉梗死患者诊断中的临床应用

The diagnostic research of MRI fluid-attenuated inversion recovery hyperintense vessel sign in acute cerebral infarction of middle cerebral artery supply zone

目的探讨磁共振T2液体衰减反转恢复序列(FLAIR)高信号血管征象(HVS)对于急性大脑中动脉区脑梗死的早期诊断的临床价值。方法回顾性分析2013年8月至2015年8月上海交通大学医学院附属苏州九龙医院神经内科住院的91例急性大脑中动脉脑梗死患者,所有患者均在24 h内进行完整磁共振成像(MRI)检查[包括FLAIR、磁共振弥散加权成像(DWI)及磁共振血管成像(MRA)]及CT血管造影(CTA)检查,观察大脑中动脉狭窄或闭塞的情况。结果 91例患者大脑中动脉从轻中度狭窄、重度狭窄到闭塞,HVS阳性所占比例分别为1/16(6%)、7/18(38%)、36/57(63%);对比重度狭窄组与轻中度狭窄组,差异有统计学意义(P=0.025),对比闭塞组与轻中度狭窄组,差异有统计学意义(P<0.01)。结论在大脑中动脉重度狭窄或闭塞的患者中T2-FLAIR序列HVS阳性率高,HVS对于急性大脑中动脉区脑梗死的早期临床诊断有重要意义。

Objective To investigate the early diagnostic value of the FLAIR HVS for patients with acute cerebral infarction of middle cerebral artery supply zone. Methods From Aug 2013 to Aug 2015, 91 patients with acute cerebral infarction of middle cerebral artery supply zone in Suzhou Kowloon Hospital were performed with MRI （including FLAIR, DWI and MRA） and CTA to observe the stenosis or occlusion status of middle cerebral artery. Results The percentage of positive HVS was 1/16（6%） in mild stenosis group, 7/18（38%） in severe stenosis group and 36/57 （63%） in occlusion group in the middle cerebral artery. Compare the mild stenosis group with severe stenosis group, P=0.025, the difference was statistically significant. Compare the severe stenosis group with occlusion group, P〈0.01, the difference was statistically significant. Conclusion T2-FLAIR HVS is important in the diagnostic evaluation of acute cerebral infarction of middle cerebral artery supply zone