头颅SWI在脑出血诊断中的临床应用价值

The application of MRI susceptibility weighted imaging on intracerebral hemorrhage

目的探讨磁敏感加权成像(SWI)在脑出血患者中诊断出血的敏感性和临床应用价值。方法前瞻性选取2016年1月至2017年1月来首都医科大学大兴医院就诊的脑出血患者共80例,采用随机数字表法将患者分为两组,每组各40例。一组行常规头颅MRI扫描,另一组行头颅磁敏感加权成像(SWI)扫描,比较两种方法检测的出血灶检出率、出血灶分布情况、扫描图像以及出血量的差异,从而评价SWI扫描对于脑出血患者的临床应用价值。结果常规MRI(Tl WI、T2WI、Flair)扫描对脑出血患者出血灶检出率为49%、51%、43%,SWI序列扫描对出脑出血患者出血灶的检出率为100%,SWI扫描组出血灶检出率显著高于常规MRI组,且差异具有统计学意义(P<0.05)。与常规MRI图像相比,SWI扫描成像结果更加清晰,分辨率更高。常规MRI组平均出血量为(34.2±9.8)ml,而SWI组平均出血量为(45.2±11.2)ml,后者出血量显著高于前者,且差异具有统计学意义(P<0.05)。结论 SWI扫描与常规MRI扫描相比,对于脑出血患者的出血灶显示更加清晰,在临床中具有较高的指导和参考意义,因此值得在临床进行推广应用。

Objective To investigate the value of MRI susceptibility weighted imaging （SWI） in the hemorrhagic sensitivity of patients with intracerebral hemorrhage. Methods 80 patients with cerebral hemorrhage who came to the neurology department of Daxing Hospital of Capital Medical University from January 2016 to January 2017 were retrospectively selected. All patients were divided into two groups with the method of random number table, 40 cases in each group. A group of routine MRI scans were performed, and the other group was scanned by magnetic sensitive weighted imaging （SWI）. The detection rate of hemorrhage, the detection rate of micro-hemorrhage, the distribution of hemorrhage, the scan images and the difference of hemorrhage volume were recorded in order to evaluate the clinical value of SWI in patients with cerebral hemorrhage. Results The detection rate of conventional MRI （TlWI, T2WI, Flair） for hemorrhagic foci in patients with cerebral hemorrhage was 100%, and the detection rate of hemorrhagic foci in patients with cerebral hemorrhage was 100%. The detection rate of bleeding in SWI scanning group was significantly higher than that in conventional MRI group, and the difference was statistically significant （ P 〈0.05）. Compared with conventional MRI images, SWI scan imaging results more clearly, higher resolution. The average amount of bleeding in the MRI group was （34.2±9.8） ml, while the average amount of bleeding in the SWI group was （45.2±11.2） ml, which was significantly higher than the former （ P 〈0.05）. Conclusion Compared with conventional MRI scans, magnetic resonance weighted imaging is more clear for hemorrhagic lesions in patients with intracerebral hemorrhage and has higher sensitivity to micro-hemorrhagic foci and higher clinical guidance and reference value, so it is worth to be used clinically to promote the application.