老年多发性脑梗塞CT、MRI征象特征及临床应用价值探讨

Features of CT and MRI Signs and Clinical Application Value in Elderly Patients with Multiple Cerebral Infarction

目的探讨200例老年多发性脑梗塞CT、MRI征象特征及临床应用价值。方法回顾分析本院2016年2月至2019年4月收治的200例多发性脑梗塞老年患者的临床资料。对MRI和CT的诊断结果进行讨论和分析;比较不同部位梗死部位的检出率及检出时间。结果CT检查的病灶数量要比MRI检查的病灶数量少,患者CT检查多发性脑梗塞微小病灶的能力显著低于MRI检查,但是在检查时间上,CT检查时间较MRI检查方法明显缩短(P<0.05)。CT检查诊断多发性脑梗死的准确率为71.00%;MRI检查诊断准确率为95.00%,明显高于CT,且与病理结果一致性良好(P<0.05)。发病24h内CT扫描缺血区可见水肿。局部脑沟消失;患者局部显示多处低密度灶。发病24小时后,梗死灶呈低密度区,边界模糊,密度不均匀。我们可以看到质量效应。MRI平扫急性期病变的血管内无流空效应,T1图像可见局部皮质信号减低,皮髓界限小时,脑沟变浅消失。T2图像病变呈浅淡的长T2现象。增强时可出现梗塞区和临近血管腔的曲线强化,增强血管主要为动脉,脑实质片状轻微强化,边界模糊不清;脑膜条状强化。亚急性期梗塞区呈典型的长T1、T2信号,形态及占位效应与CT同期表现类似。结论采用CT、MRI检查均可有效显示老年多发性脑梗塞的影像学征象,但MRI检查鉴别诊断老年多发性脑梗塞的能力优于CT检查。

Objective To explore the features of CT and MRI signs and clinical application value in 200 elderly patients with multiple cerebral infarction.Methods The clinical data of 200 elderly patients with multiple cerebral infarction admitted to our hospital from February 2016 to April 2019 were retrospectively analyzed.The diagnosis results of MRI examination and CT examination were discussed and analyzed.The detection rate and detection time of different infarction location were compared.Results The number of lesions examined by CT was less than that by MRI.The ability of CT to examine minimal lesions of multiple cerebral infarction was significantly lower than that of MRI,but in terms of inspection time,CT examination time was significantly shorter than MRI examination method(P<0.05).The diagnostic accuracy rate of CT examination for multiple cerebral infarction was 71.00%;the diagnostic accuracy rate of MRI examination was 95.00%,which was significantly higher than that of CT,and was in good agreement with the pathological results(P<0.05).Edema was seen in the ischemic area on CT scan within 24 hours of onset.The focal sulci disappeared;the patient showed multiple hypodense foci locally.24 hours after the onset of the infarct,the infarct was a low-density area with blurred borders and uneven density;mass effect was seen.There was no flow void effect in the blood vessels of the acute stage lesions of MRI plain scan,and T_(1) images showed that the local cortical signal was reduced,the cortex-medullary boundary was small,and the sulci of the brain became shallow and disappeared.On T_(2) images,the lesions showed a faint long T_(2) phenomenon.During enhancement,curvilinear enhancement of the infarct area and adjacent vascular lumen could be seen,the enhanced vessels were mainly arteries,and the brain parenchyma was slightly enhanced in flakes with blurred borders;the meninges were enhanced in strips.In the subacute phase,the infarct area showed typical long T_(1) and T_(2) signals,and the morphology and mass effect were similar to those of CT in the same period.Conclusion Both CT and MRI examinations can effectively display the imaging signs of senile multiple cerebral infarction,but MRI examination is better than CT examination in its ability to differentiate and diagnose senile multiple cerebral infarction.