CT、MRI检测早期腔隙性脑梗死的价值研究

The Clinical Diagnostic Value of CT and MRI in Early Lacunar Infarction

目的探讨CT、MRI在检测早期腔隙性脑梗死的临床价值。方法分别应用CT、MRI检测我院2015年1月-2017年6月收治250例LAC患者。结果共250例患者经CT检测后共发现451枚病灶,呈现低密度或等密度改变。MRI检测后共发现1048枚病灶。MRI组的检出率显著高于CT组(P<0.05)。CT组病灶检出直径5-18mm,平均直径(10.59±1.58)mm,≤5mm的病灶检出6枚,5-10mm的病灶检出184枚,≥10mm的病灶261枚。MRI组病灶直径2-18mm,平均直径(4.59±1.48)mm,≤5mm的病灶检出489枚,5-10mm的病灶检出290枚,≥10mm的病灶269枚。MRI组的≤5mm病灶检出率显著高于CT组(P<0.05)。CT结果显示LAC患者发生新发病灶位于基底节区、无症状性梗死、扩大血管周围间隙、颅内粥样硬化白质病变轻度比例显著高于重度患者(P<0.05)。MRI结果显示LAC患者发生新发病灶位于基底节区、无症状性梗死、扩大血管周围间隙、颅内粥样硬化白质病变重度比例显著高于轻度患者(P<0.05)。CT组平均检测时间、检测费用显著低于MRI组(P<0.05)。结论 CT及MRI均能检出早期腔隙性脑梗死病灶,MRI能显著提高微小病灶检出率,判断白质病变程度。

Objective To investigate the clinical diagnostic value of CT and MRI in early lacunar infarction（LAC）. Methods A total of 250 LAC patients treated in our hospital from January 2015 to June 2017 were given CT and MRI examination. Results A total of 451 lesions were found in 250 patients through CT examination demonstrated as hypodensity or isodensity, while a total of 1048 lesions were found through MRI detection. The detection rate in MRI group was significantly higher than that in CT group（P〈0.05）. The lesion diameter of CT group was 5-18 mm, the mean diameter was（10.59±1.58） mm, including 6 lesions size ≤ 5 mm, 184 lesions size between 5 mm to 10 mmm and 261 lesions size ≥10 mm. The lesion diameter of MRI group was 2-18 mm, the mean diameter was（4.59±1.48） mm, including 489 lesions size ≤ 5 mm, 290 lesions size between 5 mm to 10 mmm and 269 lesions size ≥10 mm. The≤ 5 mm lesions detection rate in MRI group was significantly higher than that in CT group（P〈0.05）. CT results showed that the incidence of new lesions in basal ganglia, asymptomatic infarction, enlarged perivascular space and intracranial atheromatous white matter lesions in LAC patients were significantly higher than those in severe patients（P〈0.05）. While the MRI results showed that the incidence of above disease in LAC patients were higher than that in the mild patients（P〈0.05）. The average detection time and cost of CT group were significantly lower than those of MRI group（P〈0.05）. Conclusion LAC can be detected by both CT and MRI examinations. The MRI has the advantages of higher small lesions detection rate and determining the degree of white matter disease.