磁敏感加权成像诊断腔隙性脑梗死中脑微出血的临床研究

Application of susceptibility weighted imaging in the diagnosis of cerebral microbleeding for cerebral lacunar infarction

目的探讨磁敏感加权成像(SWI)技术检测腔隙性脑梗死患者中脑微出血(CMBs)病变的价值。方法对腔隙性脑梗死组、正常对照组(各60例)研究对象均行MRI扫描,即GRE-T2*WI、SWI、FSE序列(T1WI、T2WI及T2FLAIR)常规轴位检查。结果SWI扫描序列中脑微出血的检出率最高,GRE-T2*WI次之,其他头颅常规扫描序列(T1WI、T2WI、T2FLAIR)脑微出血的检出率较低。2组患者SWI序列扫描中发现脑微出血34例84处,GRE-T2*WI序列发现脑微出血19例40处,T1WI及T2WI分别只发现脑微出血2例4处和6例11处,2组SWI序列的脑微出血病灶数高于T1WI、T2WI、T2FLAIR、GRE-T2*WI序列,差异有统计学意义(P<0.01)。在腔隙性脑梗死组中发现脑微出血26例(43.33%),正常对照组为8例(13.33%),2组相比差异有统计学意义(P<0.05)。基底节/丘脑区(BGT)脑微出血发生率高于皮质-皮质下区(CSC)和幕下区(IT)。腔隙性脑梗死组中可见轻度、中度及重度3种类型的脑微出血灶,正常对照组仅发现轻度脑微出血灶。腔隙性脑梗死组轻、中、重度患者脑微出血严重程度的差异有统计学意义(P<0.05)。结论SWI扫描序列是分析、诊断脑微出血精确、有效的技术。

Objective To evaluate the application of susceptibility-weighted imaging(SWI)in detecting scanning(CMB)lesions in lacunar cerebral infarction patients.Methods Patients in the lacunar cerebral infarction group and the normal control group(n=60)underwent MRI scanning,that is GRE-T2*WI,SWI,FSE sequences(T1WI,T2WI and T2FLAIR)routine axis examination.Results According to SWI sequence,the positive rate of CMB was the highest,followed by GRE-T2*WI,and other conventional sequence(T1WI,T2WI,and T2FLAIR)found that the positive rate of CMB was low.Furthermore,84 cases of CMB(84 lesions)were detected by SWI sequence,19 cases of CMB(40 lesions)was detected by GRE-T2*WI sequence,and 2 cases of CMB(4 lesions)and 6 cases of CMB(11 lesions)were detected by T1WI and T2WI respectively.The positive number of CMBs detected by SWI sequence was remarkably higher than those by T1WI,T2WI,T2FLAIR and GRE-T2*WI(P<0.01).There were 26 cases of microbleeding lesions(43.33%)in the lacunar infarction group and 8 cases of microbleeding lesions(13.33%)in the normal control group,which was statistically different(P<0.05).The incidence of CMB in the basal ganglia and thalami(BGT),followed by the cortico-subcortical region(CSC)and infratentorial region(IT).The lacunar cerebral infarction group presented light,medium and severe lesions of cerebral microbleeding,while the normal control group showed slight lesions.Statistical difference was found in the severity of light,medium and severe patients in the lacunar cerebral infarction group(P<0.05).Conclusions SWI sequence is an accurate and effective method for the analysis and diagnosis of cerebral microbleeding.