基于磁敏感加权成像探讨缺血性脑卒中患者脑微出血与深部脑白质缺血的相关性

Correlation between Cerebral Microbleeds and Deep Cerebral White Matter Ischemia in Ischemic Stroke Based on Susceptibility Weighted Imaging

背景近年来随着影像学技术发展,磁敏感加权成像(SWI)在脑微出血(CMBs)中的诊断价值较高。目的基于SWI,探讨缺血性脑卒中患者脑微出血与深部脑白质缺血的相关性。方法选取2020年2月至2021年2月在河北医科大学第一医院行磁共振成像检查的缺血性脑卒中患者50例,采用SWI序列诊断CMBs,其他序列诊断深部脑白质缺血。缺血性脑卒中患者CMBs分级与深部脑白质缺血分度、年龄的相关性分析采用Spearman秩相关分析。结果 CMBs于SWI序列上主要表现为低信号,直径为2~5 mm,可见均匀低信号或高低信号相间的同心圆状混杂信号,边界清晰,表面光滑,无明显水肿或占位效应;共检出CMBs病灶265个,其中大脑皮质及皮质下80个、基底核区65个、丘脑50个、脑干43个、小脑27个。Spearman秩相关分析结果显示,缺血性脑卒中患者CMBs分级与深部脑白质缺血分度(rs=0.723)、年龄(rs=0.434)呈正相关(P <0.05)。结论基于SWI发现,缺血性脑卒中患者CMBs分级与深部脑白质缺血分度、年龄呈正相关。

Background In recent years, with the development of imaging technology, susceptibility weighted imaging(SWI) has high diagnostic value in cerebral microbleeds(CMBs). Objective To investigate the correlation between CMBs and deep cerebral white matter ischemia in ischemic stroke based on SWI. Methods Fifty patients with ischemic stroke who underwent magnetic resonance imaging in the First Hospital of Hebei Medical University from February 2020 to February 2021 were selected. SWI sequence was used to diagnose CMBs, and other sequences were used to diagnose deep cerebral white matter ischemia. Spearman rank correlation analysis was used to analyze the correlation between CMBs grade, deep cerebral white matter ischemia grade and age in patients with ischemic stroke. Results CMBs mainly showed low signal on SWI sequence,between 2-5 mm in diameter,visible signal uniform low signal or high and low signal phase concentric circular hybrid signal,clear boundaries, smooth surface, no obvious edema or occupying effect. A total of 265 CMBs lesions were detected, of which 80 cerebral cortex and subcortical, 65 basal nucleus, 50 thalamus, 43 brainstem and 27 cerebellum. Spearman rank correlation analysis showed that the CMBs grade of patients with ischemic stroke was positively correlated with deep cerebral white matter ischemia degree(rs=0.723) and age(rs=0.434)(P < 0.05). Conclusion Based on SWI, the CMBs grade of patients with ischemic stroke is positively correlated with the deep cerebral white matter ischemia degree and age.