磁敏感加权成像及扩散加权成像联合常规MRI在诊断脑内小灶性出血的临床研究

Clinical Study of Magnetic Sensitive Weighted Imaging and Diffusion-weighted Imaging Combined with Conventional MRI in the Diagnosis of Intracerebral Hemorrhage

目的探讨常规颅脑平扫序列联合磁敏感加权成像(SWI)、扩散加权成像(DWI)在诊断脑小灶性出血的临床诊断价值。方法选取2021年1月至2023年1月我院收治的200例临床疑诊脑血管疾病患者作为研究对象,检查序列包括颅脑平扫序列、磁敏感加权成像及扩散加权成像序列,对符合研究标准的128例脑小灶性出血患者MRI图像进行研究,对比分析SWI、DWI、常规MRI平扫序列显示脑小灶性出血情况。结果128例中,95例高血压脑微出血灶,20例脑淀粉样变性,4例脑梗死伴出血,9例海绵状血管瘤。小灶性出血在T_(1)WI上以低信号影为主,T_(2)WI和T_(2)-FLAIR上多呈稍高信号或等信号影为主,DWI序列中以低信号或等信号影为主。小灶性出血在SWI序列中多为点状、类圆形或环形低信号影。128例脑小灶性出血患者在SWI序列、DWI序列及常规平扫序列检出阳性病例数分别为128例、96例及40例,SWI序列中出血病灶的检出率较DWI和常规MRI序列高,差异具有统计学意义(P<0.05);SWI序列在128个患者中共发现896个出血性病灶,DWI和平扫序列检测出血病灶分别为302个和67个;SWI序列发现的出血灶数量显著高于DWI和磁共振平扫,差异具有显著性(P<0.05)。并对128例脑小灶性出血部位进行了统计,235个在皮层区、216个在基底节区、208个在丘脑,237个在幕下;脑小灶性出血在不同区域的分布差异无统计学意义。结论SWI、DWI联合MRI平扫可提高脑内小灶性出血的诊断准确率,对患者相关脑内疾病的诊治与预后评价有重要临床意义。

Objective To investigate the clinical diagnostic value of conventional brain scan sequence combined with magnetic susceptibility weighted imaging(SWI)and diffusion weighted imaging(DWI)in the diagnosis of focal cerebral hemorrhage.Methods 200 patients with suspected cerebrovascular diseases from January 2021 to January 2023 were selected as the study subjects.The MRI images of 128 patients with focal cerebral hemorrhage were studied.Results Among 128 cases,95 cases were hypertensive microhemorrhage,20 cases were amyloidosis,4 cases were cerebral infarction with hemorrhage,9 cases were cavernous hemangioma.On T_(1)WI,focal hemorrhage was mainly hypointensive,on T_(2)WI and T_(2)-FLAIR,it was mainly hypointensive or isotensive,and on DWI,it was mainly hypointensive or isotensive.Focal hemorrhage in SWI sequences was dotted,round-like or circular hypointensity.In 128 patients with focal cerebral hemorrhage,there were 128,96 and 40 positive cases in SWI sequence,96 positive cases in DWI sequence and 40 positive cases in MRI sequence.The detectable rate of hemorrhagic focus in SWI sequence was higher than that in DWI sequence and MRI sequence,and the difference was statistically significant(P<0.05).In 128 patients,SWI sequence found 896 hemorrhagic focus,while DWI sequence detected 302 and 67 hemorrhagic focus respectively.The number of hemorrhagic focus in SWI sequence was significantly higher than that in DWI and MRI sequence,and the difference was significant(P<0.05).There were 235 cases in cortex,216 cases in basal ganglia,208 cases in thalamus and 237 cases in supratentorial.There was no significant difference in the distribution of focal cerebral hemorrhage.Conclusion SWI,DWI combined with MRI can improve the diagnostic accuracy of focal cerebral hemorrhage,and have important clinical significance in the diagnosis,treatment and prognosis of patients with related brain diseases.