多模式磁共振成像对急性期脑梗死预后评估的应用价值

The application of multimodal magnetic resonance imaging in prognostic evaluation of acute cerebral infarction

目的:评估MR弥散加权成像(DWI)在脑微出血(CMBs)检测中的应用价值,并探讨SWI对急性脑梗死预后的临床价值。方法:收集2022年1月—2023年12月在北京怀柔医院就诊行常规磁共振(MRI)、DWI和SWI序列扫描的急性期脑梗死患者96例,比较两序列(DWI、SWI)对CMBs检出的差异,随访3个月后患者的预后情况,分析影响预后的危险因素。结果:96例患者中SWI检出CMBs 42例384处,DWI检出37例115处。DWI与SWI检出病例数的差异无统计学意义(Z=-1.225,P=0.119),但SWI病灶数的检出率高于DWI,两者差异有统计学意义(Z=-3.127,P=0.001)。多因素分析,CMBs 2级是影响预后的独立危险因素(OR=16.551,95%CI:2.136~148.119,P=0.013)。结论:CMBs的存在及数量与急性脑梗死患者的预后相关,DWI有助于脑微出血灶的检出,但对于脑微出血数目的检出率不如SWI。

Objective To evaluate the application value of MR diffusion-weighted imaging(DWI)in the detection of cerebral microbleeds(CMBs)and explore the clinical value of susceptibility weighted imaging(SWI)in the prognosis of acute cerebral infarction.Methods A total of 96 patients with acute phase cerebral infarction who underwent routine magnetic resonance imaging(MRI),DWI,and SWI sequence scans at Beijing Huairou Hospital from January 2022 to December 2023 were collected,to compare the differences in detection of CMBs between two sequences(DWI and SWI),and evaluate the prognosis of patients after 3 months of follow-up,and analyze the risk factors affecting prognosis.Results Among 96 patients,SWI detected CMBs in 42 cases with 384 locations,while DWI detected 37 cases with 115 locations.The difference in the number of detected cases between DWI and SWI was not statistically significant(Z=-1.225,P=0.119),but the difference of detection rate between the two was statistically significant(Z=-3.127,P=0.001).Multivariate analysis showed that CMBs 2 level was an independent risk factor affecting prognosis(OR=16.551,95%CI 2.136-148.119,P=0.013).Conclusion The presence and quantity of CMBs are correlated with the prognosis of patients with acute cerebral infarction.DWI is helpful in detecting cerebral microbleeds,but the sensitivity of SWI in detecting CMBs is higher than DWI.