脑梗死与急性脑出血的磁共振DWI、SWI诊断价值评估

Evaluation of diagnostic values of magnetic resonance DWI and SWI for cerebral infarction and acute intracerebral hemorrhage

目的:探讨脑梗死(CI)与急性脑出血(AICH)的磁共振扩散加权成像(DWI)、磁敏感加权成像(SWI)诊断价值。方法:回顾性分析2014年6月至2017年6月间收治的154例CI患者(CI组)和82例AICH患者(AICH组)临床资料,两组均行DWI、SWI序列检查和常规磁共振成像(MRI)。比较两组患者病灶检出结果、影像学检查情况、表观扩散系数(ADC)及相位值(PV值)。结果:(1)两组常规MRI检查T1WI和T2WI序列病灶检出率对比,差异无统计学意义(P> 0. 05),CI组较AICH组DWI序列检出率低(P <0. 05)、SWI序列检出率高(P <0. 05);(2) DWI检查CI组脑梗部位呈高信号,AICH组血肿中心呈低信号,血肿周围呈少许高信号; SWI检查CI组脑梗部位呈等信号,AICH血肿中心呈低信号、血肿周围呈高信号;(3) CI组较AICH组病灶中心ADC值高(P <0. 05)、病灶周围ADC值低(P <0. 05),CI组出血性转化区PV值较AICH血肿区高(P <0. 05)。结论:CI患者和AICH患者在SWI和DWI中影像学表现不同,对指导临床急性脑血管疾病诊治具有重要意义。

Objective： To explore the diagnostic values of magnetic resonance diffusion-weighted imaging （DWI） and magnetic susceptibility weighted imaging （SWI） for cerebral infarction （CI） and acute intracerebral hemorrhage （AICH）. Methods： The clinical data of 154 CI patients （CI group） and 82 AICH patients （AICH group） admitted from June 2014 to June 2017 were retrospectively analyzed. The two groups were given DWI and SWI sequences examination and routine magnetic resonance imaging （MRI）. The lesion detection results, imaging examination, apparent diffusion coefficient （ADC） and phase value （PV） were compared between the two groups. Results： （1） There was no significant difference in the lesions detection rate of T1WI and T2WI sequences between the two groups by routine MRI examination （ P 〉0.05）, and the detection rate of DWI in CI group was lower than that in AICH group （ P 〈0.05） but the detection rate of SWI sequence was higher （ P 〈0.05）. （2） By DWI examination, cerebral infarction area showed significantly high signal in CI group, and hematoma center showed a low signal and surrounding hematoma showed a little high signal in AICH group. By SWI examination, cerebral infarction area showed equal signal in CI group, and hematoma center showed a low signal and surrounding hematoma showed high signal in AICH group. （3） The ADC value of lesion center in CI group was higher than that in AICH group （ P 〈0.05） while the ADC value of surrounding lesion was lower （ P 〈0.05）, and the PV value of hemorrhagic transformation area in CI group was higher than that in hematoma area of AICH group （ P 〈0.05）. Conclusion： The imaging findings of CI patients and AICH patients are different in SWI and DWI, which is of great significance for the diagnosis and treatment of clinical acute cerebrovascular diseases.