MR扩散加权成像在脑梗死缺血半暗带诊断中的应用价值探讨

The application value of MR diffusion-weighted imaging in the diagnosis of ischemic penumbra in cerebral infarction

目的探讨磁共振(MR)扩散加权成像(DWI)在脑梗死缺血半暗带诊断中的应用价值。方法298例脑梗死患者,予以MR扩散加权成像、T2加权像扫描。比较MR扩散加权成像、T2加权像的诊断准确率;病灶中心区、缺血半暗带及其对侧镜像区的表观扩散系数(ADC);超急性期、急性期患者的缺血半暗带、病灶中心区相对表观扩散系数(rADC)。结果MR扩散加权成像的诊断准确率为100.00%,显著高于T2加权像的88.59%,差异具有统计学意义(χ^(2)=36.06,P<0.05)。患者病灶中心区ADC为(3.92±1.44)×10^(-4) mm^(2)/s,对侧镜像区ADC为(7.62±1.05)×10^(-4) mm^(2)/s;患者缺血半暗带ADC为(8.02±0.62)×10^(-4) mm^(2)/s,对侧镜像区ADC为(8.33±0.45)×10^(-4) mm^(2)/s;患者病灶中心区和对侧镜像区的ADC显著低于缺血半暗带和对侧镜像区的ADC,差异具有统计学意义(P<0.05)。超急性期患者缺血半暗带、病灶中心区的rADC显著低于急性期,差异具有统计学意义(P<0.05)。结论针对脑梗死缺血半暗带患者,选择MR扩散加权成像能快速确诊患者病情,明确病症发展进程,为其后续治疗和预后提供科学依据,应用价值显著,值得推广。

Objective To discuss the application value of magnetic resonance(MR)diffusion-weighted imaging(DWI)in the diagnosis of ischemic penumbra in cerebral infarction.Methods 298 patients with cerebral infarction received MR diffusion-weighted imaging and T2-weighted imaging scan.Comparison was made on diagnostic accuracy of MR diffusion-weighted imaging and T2-weighted imaging;the apparent diffusion coefficient(ADC)of the central area of the lesion,the ischemic penumbra and their contralateral mirror area;the relative apparent diffusion coefficient(rADC)of the ischemic penumbra and the central area of the lesion in patients at hyperacute phase and acute phase.Results The diagnostic accuracy of MR diffusion-weighted imaging was 100.00%,which was significantly higher than 88.59%of T2-weighted imaging,and the difference was statistically significant(χ^(2)=36.06,P<0.05).The ADC was(3.92±1.44)×10^(-4) mm^(2)/s in the central area of the lesion and(7.62±1.05)×10^(-4) mm^(2)/s in its contralateral mirror area;the ADC was(8.02±0.62)×10^(-4) mm^(2)/s in the ischemic penumbra,and(8.33±0.45)×10^(-4) mm^(2)/s in its contralateral mirror area.The ADC of the central area of the lesion and its contralateral mirror area were significantly lower than those of the ischemic penumbra and its contralateral mirror area,and the difference was statistically significant(P<0.05).The rADC in the ischemic penumbra and the central area of the lesion in patients at hyperacute phase was significantly lower than that patients at acute phase,and the difference was statistically significant(P<0.05).Conclusion For patients with ischemic penumbra in cerebral infarction,MR diffusion-weighted imaging can be used to diagnose the condition of patients rapidly,clarify the course of disease development,and provide scientific basis for follow-up treatment and prognosis.It has significant application value,and is worthy of promotion.