磁共振常规序列及ASL诊断急性脑梗死价值对比

Comparison of Diagnostic Value of Routine Sequence and ASL in Acute Cerebral Infarction

目的评价磁共振常规序列T2加权成像(T2 weighted imaging,T2WI)、液体衰减翻转恢复(fluid liquid attenuated inversion recovery,FLAIR)、弥散加强成像(diffusion weighted imaging,DWI)、动脉自旋标记(arterial spin labeling,ASL)在急性期脑梗死中的不同诊断价值。方法回顾性分析我院2019年3月—2020年3月在发病72 h内完成MRI检查的急性期脑梗死患者73例,扫描序列至少包括T2WI、FLAIR、DWI、ASL,记录各序列急性期脑梗信号特点并勾画病变区面积。结果73例弥散加权成像均呈高信号,发病12 h内完成检查13例,T2WI序列呈高/稍高/等信号,FLAIR呈高/稍高信号,ASL呈低灌注状态,低灌注范围明显大于其他序列;发病12~24 h完成检查52例,T2WI序列呈高/稍高信号,压水序列呈高/稍高信号,ASL呈低灌注状态,低灌注范围大于其他序列;发病72 h内完成检查8例,T2WI序列呈稍高信号/高信号,压水序列呈高/混杂信号,ASL 6例呈低灌注内有散在高灌注,2例呈低灌注,灌注异常范围大于或等于其他序列;采取随机区组设计多个样本比较秩和检验,T2WI、压水、弥散与灌注成像显示病灶面积比较,χ2=189.31,P=0.00,有显著统计学差异。结论常规扫描结合弥散和ASL功能成像能够准确判断病灶大小、累及区域、组织灌注状态,对于临床考虑急性期脑梗死患者可T2WI、FLAIR、DWI、ASL一站式完成扫描。

Objective To evaluate the diagnostic value of T2WI,FLAIR,DWI and ASL in acute cerebral infarction.Methods 73 patients with acute cerebral infarction who completed MRI examination within 72 hours in our hospital from March 2019 to March 2020 were retrospectively analyzed.The scan sequence included at least T2WI,FLAIR,DWI and ASL.The signal characteristics of each sequence of acute cerebral infarction were recorded and the lesion area was delineated.Results All the 73 patients showed high signal in DWI,and 13 patients were examined within 12 hours.T2WI sequences showed high/slightly high/equal signal,FLAIR showed high/slightly high signal,ASL showed low perfusion,and the range of low perfusion was significantly greater than other sequences.52 patients were examined within 12 to 24 hours,the T2WI sequence presented high/slightly high signal,FLAIR presented high/slightly high signal,and the ASL showed low perfusion,and the low perfusion range was greater than other sequences.8 patients were examined within 72 hours.The T2WI sequence presented slightly higher signal/high signal,and FLAIR presented high/mixed signal,while the ASL sequence presented scattered high perfusion in 6 cases and low perfusion in 2 cases.The range of perfusion abnormalities was greater than or equal to other sequences.The ranch-sum test was used to compare multiple samples in the random area group,and the difference was statistically significant in the area of the lesions shown by T2WI,FLAIR,DWI and ASL,χ2=189.31,P=0.00.Conclusion Conventional scanning combined with DWI and ASL functional imaging can accurately determine the size of the lesion,the region involved and the tissue perfusion status.For patients with clinical acute cerebral infarction,one-stop scanning including T2WI, FLAIR, DWI and ASL can be completed.