FLAIR与SWI大脑中动脉血管征对急性缺血性脑卒中诊断价值研究

Diagnosis value of high signal in middle cerebral artery on FLAIR and SWI of acute ischemic stroke

目的:探讨3.0T磁共振的液体衰减反转恢复成像序列(FLAIR)的高信号血管征(HVS)与磁敏感加权成像(SWI)对急性缺血性脑卒中(AIS)临床对比研究应用价值。方法:62例AIS(<72 h)均行常规MRI、MRA及SWI检查患者,利用FLAIR与SWI联合应用对AIS的近端HVS与血管磁敏感征(SVS)和远端HVS与病灶周围软脑膜血管的侧支循环血管扩张程度相关性分析。结果:在62例AIS中大脑中动脉(MCA)近端高信号HVS阳性39例,阴性23例,分别占总数62.9%、37.1%;远端HVS阳性51例、阴性11例,分别占总数82.2%、17.8%;SVS阳性53例、阴性9例,分别占总数85.5%、14.5%;病灶周围软脑膜血管与同镜像区扩张49例,无扩张13例,分别占总数79.0%、20.1%;AIS的近端HVS征与SWI的SVS征责任血管相关性分析,对t检验具有统计学意义(χ~2=8.255,P=0.004,<0.01)。MCA远端在T2 FLAIR的HVS征与病灶周围有、无软脑膜血管显示程度相关性分析对t检验具有一致性(χ~2=0.207,P=0.649>0.05)。结论:MCA的SVS和近端HVS对AIS的责任血管具有明显一致性,且SWI对MCA的血栓检出率明显优于T2 FLAIR,MCA远端的HVS征与病灶周围有、无软脑膜血管具有一致性,同时对危重患者优化检查流程,为临床制定正确的治疗方案和预后判断具有重要临床意义。

Objective： To investigate the value of high signal vascular sign（HVS） at fluid attenuated inversion recovery imaging（FLAIR） and susceptibility weighted imaging（SWI） in 3.0T magnetic resonance for acute ischemic stroke（AIS）. Methods： Sixty-two patients of AIS（〈72 h） were underwent MRI. We studied the correlation between proximal HVS of AIS, susceptibility vessel sign（SVS） and distal HVS, dilation of vessels around pia mater combined with FLAIR and SWI. Results： There are 39 cases（62.9%） with proximal HVS of middle cerebral artery（MCA）, 51 cases（82.2%） with distal HVS, 53 cases（85.5%） with SVS and 49 cases（79.0%） with dilation of vessels around pia mater. It has correlation between HVS at FLAIR and SVS at SWI of the offending vessel（χ2=8.255, P=0.004）. There was consistency between distal HVS of MCA and vessels of pia mater around lesions（χ2=0.207, P=0.649〉0.05）. Conclusion： There are consistency between SVS of MCA and approximal HVS of offending vessels, distal HVS of MCA and vessels of pia mater around lesions. The detection rate of MCA thrombus at SWI is higher than FLAIR. It is very important to optimize the exam process, make the correct treatment plan and prognosis.