磁敏感成像技术联合脑CT灌注成像在急性脑梗塞伴微出血诊断中的应用

Application of susceptibility weighted imaging combined with cerebral CT perfusion imaging in the diagnosis of acute cerebral infarction with microbleeds

目的探讨磁敏感成像技术(SWI)联合脑CT灌注成像在急性脑梗塞伴微出血诊断中的应用效果。方法选取2020年1月至2020年12月九江市第一人民医院收治的60例急性脑梗塞伴微出血患者作为研究对象,所有患者均接受SWI联合脑CT灌注成像检查,记录患者脑微出血病灶分布情况。比较病灶区与镜像健侧区CT灌注参数[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)和到达峰值时间(TTP)]及脑磁共振SWI序列脑微出血病灶检查结果。结果60例患者脑微出血病灶分布区域:脑叶型20例,幕下型7例,深部脑组织型25例,多区域型8例;多区域型与深部脑组织型的分级高于脑叶型与幕下型,差异有统计学意义(P<0.05);病灶区CBV、CBF低于镜像健侧区,MTT短于镜像健侧区,TTP高于镜像健侧区,差异有统计学意义(P<0.05)。结论SWI联合脑CT灌注成像在急性脑梗塞伴微出血诊断中的应用价值较高,可准确诊断微出血病灶,值得临床推广应用。

Objective To investigate the application effect of susceptibility weighted imaging(SWI)combined with cerebral CT perfusion imaging in the diagnosis of acute cerebral infarction with microbleeds.Methods 60 patients with acute cerebral infarction with microbleeds in the first People's Hospital of Jiujiang City from January 2020 to December 2020 were selected as the research subjects,all patients underwent SWI combined with cerebral CT perfusion imaging to record the distribution of cerebral microbleeds.The CT perfusion parameters(cerebral blood volume[CBV],cerebral blood flow[CBF],mean transit time[MTT]and time to peak[TTP])and the results of SWI sequence of cerebral microbleeds were compared.Results The distribution areas of cerebral microhemorrhage lesions in 60 patients were:20 cases of lobar type,7 cases of infratentorial type,25 cases of deep brain tissue type,and 8 cases of multi regional type.The classification of multi regional type and deep brain tissue type was higher than lobar type and infratentorial type,and the difference was statistically significant(P<0.05).The CBV,CBF in the lesion area were lower than the contralateral area,MTT was shorter than the contralateral area,and the TTP was higher than the contralateral area,and the difference was statistically significant(P<0.05).Conclusion The application value of SWI combined with cerebral CT perfusion imaging in the diagnosis of acute cerebral infarction with microbleeds is high,which can accurately diagnose microbleeding lesions and is worthy of clinical application.