磁共振SWI在急性脑梗死溶栓诊疗中的应用价值

The application value of magnetic resonance SWI in the diagnosis and treatment of acute cerebral infarction

目的探讨磁共振磁敏感加权成像(SWI)在急性脑梗塞溶栓诊疗中的应用。方法 56例急性脑梗死患者,入院时均行常规MRI及SWI扫描,根据SWI是否有脑组织微量出血(CMBs),将其分为CMBs组21例和无CMBs组35例。静脉溶栓后,复查SWI检测计数发生出血转化(HT)的例数,对比CMBs组和无CMBs组是否存在统计学差异(P <0. 05)。结果静脉溶栓治疗后,CMBs组21例脑梗死13例发生HT,无CMBs组35例仅5例发生HT,2组HT发生存在统计学差异(P <0. 05)。结论磁共振SWI敏感检测梗死灶内是否伴有微出血,间接评估血脑屏障(BBB)及血管壁状态,对临床静脉溶栓治疗具有重要指导意义。

Objective To investigate the application of susceptibility weighted imaging （SWI） in the diagnosis and treatment of acute cerebral infaretion. Methods 56 patients with acute cerebral infaretion were collected in this study. All patients were scanned with routine MRI and SWI. According to the presence of CMBs on SWI, the patients were classified into two groups： CMBs group （21 cases） with CMBs and NO CMBs groups （35 cases） without CMBs. After intervenous thrombolysis, the number of hemorrhagic transformation （HT） was counted by SWI, and compared between CMBs group and NO CMBs group （ P 〈 0. 05）. Results After intravenous thrombolytie therapy of acute infaretion, 13 eases presented with HT among CMBs group, and only 5 eases with HT among NO CMBs group,there was significant statistically difference between two groups （ P 〈 0. 05）. Conclusion SWI sequence has greate sensitivity in detecting CMBs, and can also assess the state of blood brain barrier （BBB） and vascular wall indirectly, which has important guiding significant for the theatment of intravenous thrombolytic therapy.