磁共振成像对急性脑梗死和脑转移瘤的鉴别诊断

Antidiastole value of magnetic resonance imaging in acute cerebral infarction and cerebral metastatic tumor

目的研究急性脑梗死(ACI)和脑转移瘤(BM)的磁共振特征,分析磁共振在两者影像学诊断中的鉴别价值。方法收集急性脑梗死46例,脑转移瘤患者30例。行头磁共振平扫及增强检查,对二者进行鉴别诊断。结果BM组较ACI组的多发病灶病例数明显增多。2组新发病灶在分布部位上比较,分布无明显差异。脑转移瘤组患者的周围水肿程度显著高于急性脑梗死组,有显著性差异(P<0.05)。急性脑梗死组4例有轻微强化病灶,脑转移瘤组有程度不同的环状或实质性强化。ACI组有2例符合ACI的诊断标准,但在DWI上未显示。其余患者均可在DWI上呈现出高信号影。明显多于BM组。结论以中枢神经系统症状发病的急性脑梗死和脑转移瘤在磁共振表现上存在诸多差异。通过观察分析,其特征表现助于两者的鉴别诊断。

Objective To study the characteristics of magnetic resonance imaging(MRI)in acute cerebral infarction(ACI)and cerebral metastatic tumor(BM),antidiastole value of MRI in ACI and BM was analyzed.Methods 46 patients with ACI and 30 patients with BM were collected.Head MRI plain scan and contrast-enhanced MRI were performed,and antidiastole was made between them.Results The number of multiple lesions in BM group was significantly higher than that in ACI group.There was no significant difference in the distribution of new lesions between the two groups.There was no edema around the focus of acute cerebral infarction in ACI group,but the degree of peritumor edema and the number of cases in BM group were significantly higher than those in ACI group.In ACI group,except for 4 cases of early large area cerebral infarction with slight enhancement,no enhancement was found in other cases,while most of the cases in BM group had circular or substantial enhancement in varying degrees.In ACI group,2 cases met the diagnostic criteria of acute cerebral infarction,but DWI did not show it.The other cases were clearly shown as hyperintensity on DWI,which was significantly higher than that in BM group.Conclusion There are many differences in MRI findings between ACI and BM with central nervous system symptoms.Through the observation and analysis,its characteristic manifestation is helpful to the antidiastole of the two.