比较CT、MRI对急性脑梗死患者早期诊断的意义

Comparison on significance of CT and MRI for early diagnosis of acute cerebral infarction patients

目的探讨CT、磁共振成像(MRI)两种方法哪种更适合对急性脑梗死患者进行早期诊断。方法 97例急性脑梗死患者均使用CT与MRI检查方法进行检测,以MRI诊断结果为研究组,以CT诊断结果为对照组,并与最终诊断结果进行对照,观察两组检测效果。结果最终检测出病灶数259个,其中,皮质梗死灶70个,放射冠梗死灶50个,基底节区梗死灶60个,小脑梗死灶65个,脑干梗死灶14个;研究组与最终结果相符病灶数为234个,其中,皮质梗死灶64个,放射冠梗死灶43个,基底节区梗死灶52个,小脑梗死灶61个,脑干梗死灶14个;对照组与最终结果相符病灶数为128个,其中,皮质梗死灶42个,放射冠梗死灶21个,基底节区梗死灶31个,小脑梗死灶24个,脑干梗死灶10个;两组不同部位梗死灶检出数量比较,差异具有统计学意义(P<0.05)。研究组脑梗死总检出率为81.44%,明显高于对照组的48.45%,差异具有统计学意义(P<0.05)。97例患者中发病12 h内65例,发病12~24 h15例,发病24 h以上17例;研究组发病12 h内检出62例,发病12~24 h检出10例,发病24 h以上检出7例;对照组发病12 h内检出31例,发病12~24 h检出14例,发病24 h以上检出2例;两组不同发病时间脑梗死检出情况比较,差异具有统计学意义(P<0.05)。分析发现使用MRI与CT对发病后12 h内的急性脑梗死患者进行检查效果最好,随着发病后时间的逐渐增加,其检测的效果也逐渐减弱。结论使用MRI的早期诊断结果更为准确,此技术对急性脑梗死的早期诊断有着极为重要的意义,并可联合CT对急性脑梗死患者进行早期诊断,值得推广。

Objective To investigate the suitable method for early diagnosis of acute cerebral infarction patients between CT and magnetic resonance imaging（MRI）. Methods A total of 97 acute cerebral infarctionpatients all examined by CT and MRI. MRI diagnostic results were taken as research group, and CT diagnostic results as control group. The results were compared with the final diagnostic results to observe the test effects of two groups. Results There were 259 lesions by final test, including 70 cortical infarcts, 50 coronal infarcts, 60 basal ganglia infarcts, 65 cerebellar infarcts and 14 brain stem infarcts. The research group had 123 lesions consistent with the final results, including 64 cortical infarcts, 43 coronal infarcts, 52 basal ganglia infarcts, 61 cerebellar infarcts and 14 brain stem infarcts. The control group had 128 lesions consistent with the final results, including 42 cortical infarcts, 21 coronal infarcts, 31 basal ganglia infarcts, 24 cerebellar infarcts and 10 brain stem infarcts. There was no statistically significant difference in number of infarcts detected in different parts（P〈0.05）. The research group had obviously higher total detectable rate of cerebral infarction as 81.44% than 48.45% in the control group, and the difference had statistical significance（P〈0.05）. Among 97 cases, there were 65 cases within 12 h of onset, 15 cases in 12~24 h of onset, and 17 cases in 24 h above of onset. There were 62 cases detected within 12 h of onset, 12 cases detected in 12~24 h of onset, and 7 cases detected in 24 h above of onset in the research group. There were 31 cases detected within 12 h of onset, 14 cases detected in 12~24 h of onset, and 2 cases detected in 24 h above of onset in the control group. Both groups had statistically significant difference in detection of cerebral infarction at different time of onset（P〈0.05）. Analysis showed that MRI and CT had best test effect for acute cerebral infarction within 12 h of onset. With the increasing of the onset time, the effect of the test was gradually reduced. Conclusion The early diagnostic result of MRI is more accurate, and this technique is of great importance to the early diagnosis of acute cerebral infarction. It can be combined with CT for early diagnosis of acute cerebral infarction, and it is worth popularizing.