MRI扫描ADC值及PWI对评估脑梗死患者脑组织缺血程度可行性研究

Feasibility of ADC and PWI in the Evaluation of Degree of Cerebral Ischemia of Patients with Cerebral Infarction in MRI Scan

目的探讨MRI扫描中,表面弥散系数(ADC)值和灌注成像(PWI)对评估脑梗死患者脑组织缺血程度的可行性,观察其梗死变化。方法收集我院2017年1月至2019年1月收治的42例脑梗死患者的临床、影像学资料,对患者不同时间MRI图像表现进行分析,以同侧正常部位为对照组,分析不同组别MRI检查ADC、PWI值及是否存在半暗带等情况。结果腔隙性脑梗在急性期ADC值明显低于慢性期,急性期、慢性期腔梗阻ADC值分别为(0.512±0.053)、(1.245±0.077),高于对照组(P<0.05),经PWI序列检查无半暗带区存在。慢性期大面积脑梗死病灶中心、病灶周围ADC值明显高于急性期(P<0.05);病灶中心急性期ADC值低于对照组,慢性期高于对照组(P<0.05);急性期、慢性期病灶周围ADC值均低于对照组(P<0.05);83.33%急性期患者PWI存在半暗带区,慢性期患者无半暗带区出现(P<0.05)。结论 MRI扫描ADC值及PWI可有效评估脑梗死患者脑组织缺血程度,能反映脑组织缺血程度及侧支情况,为临床治疗提供参考依据。

Objective To explore the feasibility of apparent diffusion coefficient(ADC)and perfusion weighted imaging(PWI)in the evaluation of degree of cerebral ischemia of patients with cerebral infarction in MRI scan,and to observe the infarct changes.Methods The clinical and imaging data of 42 patients with cerebral infarction admitted to our hospital from January 2017 to January 2019 were collected.The MRI images of patients in different time were analyzed.The ipsilateral normal site was used as a control group to analyze the ADC,PWI values,and the presence of penumbra in MRI examinations of different groups.Results The ADC value of lacunar infarction in the acute phase was significantly lower than that in the chronic phase.In the acute phase and chronic phase,the ADC values of luminal obstruction were(0.512±0.053)and(1.245±0.077),respectively,which were higher than those in the control group(P<0.05).By the PWI sequence examination,no penumbra zone exists.The ADC value of the lesion center and around lesions in the large area of cerebral infarction in the chronic phase was significantly higher than that in the acute phase(P<0.05).The ADC value of the lesion center in the acute phase was lower than that in the control group,and the ADC value in the chronic phase was higher than that in the control group(P<0.05).The ADC values around the lesions in the acute phase and the chronic phase were lower than those in the control group(P<0.05).83.33%patients in acute phase had a penumbra zone in PWI,and patients in the chronic phase had no penumbra zone(P<0.05).Conclusion The ADC value and PWI of MRI scan can effectively evaluate the degree of cerebral ischemia of patients with cerebral infarction,and can reflect the degree of cerebral ischemia and collaterals,which provides a reference for clinical treatment.