脑梗死与脑出血急性期应用DWI联合SWI诊断的价值

Value of DWI Combined SWI Diagnosis Applied in Cerebral Infarction and Acute Phase of Cerebral Hemorrhage

目的探讨脑梗死与脑出血急性期应用磁共振弥散加权成像(DWI)联合磁敏感加权成像(SWI)诊断的临床价值。方法选取2014年5月-2015年5月我院收治的60例急性脑梗死患者(A组)和24例急性脑出血患者(B组)为研究对象,所有患者均行1.5T磁共振DWI和SWI序列检查,观察两组患者的检查结果,并与12例正常自愿者(对照组)作比较。结果 A组急性期DWI信号较高,且随着时间的推移,信号增强越明显,病灶边界由模糊转为清晰,阳性率为100.0%,且SWI呈等信号;B组急性期DWI血肿中心信号为低信号,周围呈高信号,且随着时间的推移信号增强,SWI为均匀低信号。与对照组相比,A组ADC值降低,但降低幅度不大,且随着时间推移逐渐下降,B组ADC值明显降低,但随着时间的推移无明显改变,且B组ADC值下降幅度大于A组,P<0.05;A组PV值正常,但出血性转化时,局部PV值降低,B组PV值明显降低,且B组PV值下降幅度大于A组,P<0.05。结论脑梗死与脑出血急性期DWI和SWI检查的影像学表现不同,而DWI联合SWI应用于急性脑血管疾病的检查中,可提高诊断的准确率,有助于及时检测出脑梗死后出血性转化,对临床治疗具有重要价值。

Objective To explore clinical value of magnetic resonance diffusion weighted imaging（DWI） combined with magnetic sensitive weighted imaging（SWI） in the diagnosis of cerebral infarction and acute phase of cerebral hemorrhage. Methods Sixty patients with acute cerebral infarction（Group A） and 24 patients with acute cerebral hemorrhage（Group B） admitted by the Hospital from may, 2014 to may, 2015 were selected as research subjects, all patients underwent 1.5T magnetic resonance DWI and SWI sequence examinations, test results of patients in two groups were observed, and they were compared to those of 12 normal volunteers（control group）. Results DWI signal of patients at acute stage in Group A was higher, and the signal intensified with the passage of time, borders of lesions converted from fuzziness to clearness, the positive rate was 100.0%, and SWI showed equisignal signs. Acute DWI hematoma center showed low signal in Group B, periphery took high signal, and the signal intensified with the passage of time, while SWI was uniform low signal. ADC value in Group A significantly decreased when compared to that of patients in the control group, but the decrease extent was not significant when compared to that of patients in the control group, and gradually decreased as the elapse of time, ADC value of patients in Group B significantly decreased, but no obvious change occurred with the passage of time, and the decrease degree of ADC value in Group B was significantly greater than that of patients in Group A（P〈0.05）. PV value of patients in Group A was normal, but local PV value decreased when hemorrhagic transformation occurred, and the decrease degree of PV value of patients in Group B significantly was greater than that of patients in Group A（P〈0.05）. Conclusion Imaging appearances of DWI and SWI examinations during cerebral infarction and acute phase of cerebral hemorrhage are different, and DWI combined SWI applied in acute cerebrovascular disease inspection can improve the diagnostic accuracy, contributes to timely detect hemorrhagic transformation after cerebral infarction, and delivers important value for clinical treatment.