磁共振弥散加权及灌注加权成像对诊断不同时期脑梗死的临床效果

Clinical Effect of Diffusion Weighted and Perfusion Weighted Magnetic Resonance Imaging in Diagnosis of Cerebral Infarction at Different Stages

目的 探究磁共振弥散加权成像(DWI)及灌注加权成像(PWI)对不同时期脑梗死的诊断效果。方法 将2020年11月-2022年8月于本院收治的脑梗死患者中抽出123例作为观察对象,根据其发病时间分为34例超急性期,64例急性期,7例亚急性期,18例慢性期,均予以其进行DWI、PWI检测,分析不同分期脑梗患者头部DWI、PWI变化。结果 超急性期和急性期患者患侧脑组织DWI中ADC值显均较健侧脑组织低,亚急性期和慢性期患者患侧脑组织DWI中ADC值较健侧脑组织高(P<0.05);在超急性期患者中,以CBV、CBF降低和MTT、TTP延长为主;急性期患者中,以CBV、CBF降低和MTT、TTP延长为主;亚急性期患者,以CBV、CBF正常和MTT、TTP延长为主;慢性期患者中,CBV、CBF降低,2例患者MTT、TTP表现延长,其余均是降低;超急性期患者信号异常区域特征在于DWI<PWI,急性期患者以DWI>PWI为主要特征,亚急性期和慢性期患者则是以DWI=PWI为主要特征。结论 PWI可以清晰呈现脑梗死的缺血半暗区,DWI能突出脑梗病灶,二者结合可反映脑梗死各阶段的血流状况,为临床制定有效治疗措施提供科学依据,值得推广。

Objective To investigate diagnostic effect of diffusion weighted imaging(DWI)and perfusion weighted imaging(PWI)at different stages of cerebral infarction.Methods The paper chose 123 patients with cerebral infarction admitted to our hospital from November 2020 to August 2022 as observation objects,and divided them into 34 cases of hyperacute phase,64 cases of acute phase,7 cases of subacute phase and 18 cases of chronic phase according to their onset time,all of them were tested for DWI and PWI,changes of head DWI and PWI of patients with cerebral infarction at different stages were analyzed.Results ADC values in affected brain tissue DWI of patients at hyperacute and acute stages were significantly lower than healthy brain tissue,while ADC values in affected brain tissue DWI of patients in subacute and chronic stages were higher than healthy brain tissue(P<0.05).Patients with hyperacute phase showed CBV and CBF decrease and prolonged MTT and TTP mainly;acute phase patients showed CBV and CBF decrease and prolonged MTT and TTP mainly.Patients at subacute phase showed normal CBV and CBF,and prolonged MTT and TTP,patients with chronic phase showed CBV and CBF decrease,and 2 cases showed prolonged MTT and TTP manifestations,the rest decreased.Characteristic of abnormal signal areas of hyperacute phase patients was DWI<PWI,acute phase patients showed main feature of DWI>PWI,and subacute and chronic phase patients showed main feature of DWI=PWI.Conclusion PWI can clearly present ischemic penumbra of cerebral infarction,while DWI can highlight cerebral infarction lesion.Combination of them can reflect blood flow status of each stage of cerebral infarction,provide scientific basis for effective clinical treatment measures,which worthy of promotion.