高场强MRI扫描DWI联合SWAN序列诊断老年原发性高血压脑出血的应用价值评价

Evaluation of the Application Value of High-Field MRI Scanning DWI Combined with SWAN Sequence in the Diagnosis of Senile Primary Hypertensive Intracerebral Hemorrhage

目的:探究高场强磁共振成像(Magnetic Resonance Imaging,MRI)扫描弥散加权成像(Diffusion Weighted Imaging,DWI)联合T2血管加权成像(T2 Star-Weighted Angiography,SWAN)序列诊断老年原发性高血压脑出血的应用价值。方法:回顾性分析2016年10月~2021年10月接受诊治的老年原发性高血压合并脑出血患者98例的临床资料,全部患者均接受了多序列的MRI检查,对DWI及SWAN序列上老年原发性高血压脑出血的表现特征进行观察及总结。结果:该组老年原发性高血压脑出血共98例,包括了112个病灶,在行MRI DWI+SWAN序列扫描时分别与MRI DWI序列、MRI SWAN序列相比,诊断敏感度及准确率均较高,差异有统计学意义(P<0.05)。行T1WI序列检查时表现出了低信号或者等信号,出血区呈现出明显的斑点状,最大的出血总面积占120mm^(2);T2WI序列检查时可见病灶呈现出明显的低信号,其中23例在检查时可观察到出血病灶周围出现了较高信号的水肿带,但水肿带的范围相对较窄,病灶最大出血面积总面积占240mm^(2)。在DWI序列中能够观察到,绝大多数的高血压脑出血可观察到明显的混杂信号,在血肿周围可存在高信号,但在血肿的中央可观察到极低的信号,且边缘信号呈现出线状中心的信号较低,最大出血点总面积达到275mm^(2)。SWAN序列所显示出的出血病灶边界更加清晰,且边缘较为锐利。结论:高场强MRI扫描DWI联合SWAN序列诊断老年原发性高血压脑出血可有效地显示出患者的图像表现,可获得较高的敏感度及准确率,为疾病诊断及治疗提供合理的依据。

Objective: To explore and analyze the application value of high field intensity MRI scanning DWI combined with SWAN sequence in the diagnosis of senile primary hypertensive intracerebral hemorrhage. Methods: The clinical data of 98 elderly patients with essential hypertension and cerebral hemorrhage who were diagnosed and treated from October 2016 to October 2021 were retrospectively analyzed. All patients received multi-sequence MRI examinations. To observe and summarize the performance characteristics of primary hypertensive intracerebral hemorrhage in the elderly. Results: There were 98 elderly patients with primary hypertensive intracerebral hemorrhage in this group, including 112 lesions. Compared with MRI DWI sequence and MRI SWAN sequence, the diagnostic sensitivity and accuracy of MRI DWI+SWAN sequence were both higher than those of MRI DWI sequence and MRI SWAN sequence. higher, the difference was statistically significant(P<0.05). T1WI sequence examination showed hypointensity or isointensity, the hemorrhage area showed obvious speckle, and the largest total hemorrhage area accounted for 120mm^(2);During T2WI sequence examination, the lesions showed obvious hypointensity, of which 23 cases were examined at the time of examination. It can be observed that a high signal edema zone appears around the bleeding lesion, but the range of the edema zone is relatively narrow, and the total area of the largest hemorrhage area of the lesion is 240mm^(2). It can be observed in the DWI sequence that in the vast majority of hypertensive intracerebral hemorrhages, obvious mixed signals can be observed. There may be high signals around the hematoma, but very low signals can be observed in the center of the hematoma, and the edge signals appear as lines. The signal in the center of the hemorrhage was low, and the total area of the largest hemorrhage point reached 275mm^(2). The boundary of the hemorrhagic lesions displayed by the SWAN sequence was clearer and the edges were sharper. Conclusion: High-field-intensity MRI scanning DWI combined with SWAN sequence in the diagnosis of senile primary hypertensive intracerebral hemorrhage can effectively display the image manifestations of patients, obtain high sensitivity and accuracy, and provide a reasonable basis for disease diagnosis and treatment.