血液病患者脑梗死的MRI分析

MRI analysis of cerebral infarction of hematopathy patient

目的:分析血液病患者伴发脑梗死的原因及MRI影像学表现,提高对血液病患者脑梗死的认识及诊断水平。方法:回顾性分析某院2010年4月至2015年11月期间36例血液病脑梗死患者资料,分析受累血管、病变分布及MRI信号的特点。结果:36例血液病脑梗死患者中,12例患者为单一动脉受累,24例为多支动脉受累;31例为脑内多发梗死灶,单发梗死灶仅5例。病灶在T_2WI中呈长或稍长T_2信号,在扩散加权成像(diffusion-weighted imaging,DWI)中呈高信号,增强扫描无强化或梗死灶边缘出现脑回样强化。结论:MRI诊断血液病脑梗死与CT比较具有明显优势,对病变的发现、诊断具有重要价值,但需要与血液病脑内早期感染及脑实质浸润等鉴别。血液病患者出现中枢神经系统症状,尤其脑梗死临床症状,首选MRI检查。

Objective To enhance the diagnosis of cerebral infarction of the hematopathy patient by analyzing its causes and MRI manifestations. Methods Totally 36 hematopathy patients with cerebral infarction from April 2010 to November 2015 had their data discussed retrospectively on involved vessel, anatomic distribution and MRI manifestations. Results Of the 36 patients, 12 ones had only an artery involved in and 24 ones had multi arteries affected, 31 ones had multi cerebral infarction foci and 5 ones had single focus. The foci had high or slightly high signals in T_2WI and very high signals in DWI, and there were no enhancement or only gyrus-like enhancement around the foci found by enhanced scan. Conclusion MRI gains advantages over CT when used to diagnose and find the hematopaty patient with cerebral infarction, when it has to be differentiated with cerebral early infection and parenchymal infiltration. It＇s suggested that the hematopathy patient has to undergo MRI examination in case central nervous system symptoms especially cerebral infarction occur.