磁共振弥散加权成像对急性半卵圆中心脑梗死的评价

Acute centrum ovale infarction:evaluation with diffusion-weighted magnetic resonance imaging

目的 评价弥散加权成像 (DWI)诊断急性半卵圆中心脑梗死的价值 ;探讨半卵圆中心梗死的病因及发病机制。方法 5 8例患者在发病不同时间内行MRI T1WI、T2 WI及DWI检查 ,比较三者对半卵圆中心梗死诊断的敏感性和特异性。结果 DWI对发病 7d内的半卵圆中心梗死诊断的灵敏度为 96 4 % ,特异度为 98 8% ,与常规MRI比较 ,差异有显著意义。 5 8例患者中 ,6 2 1%有大血管及 (或 )栓塞性心脏病病变 ,6 9 0 %症状急性发作 ,有“腔隙”样症状的患者占总数的 36 2 %。结论 DWI诊断急性半卵圆中心梗死具有高度的敏感性及特异性 ,能鉴别急性与非急性病灶 ;急性半卵圆中心梗死与大血管病变及心脏病有关 ,并应与腔隙性梗死相鉴别。

Objective To evaluate the value of diffusion-weighted imaging (DWI)in diagnosing the acute centrum ovale infarction, and also to investigate the pathogenesis of the infarction. Methods All 58 patients underwent conventional MRI and DWI scanning after symptoms’ onset. DWI findings were compared to the findings of T_1WI and T_2WI. Results The sensitivity and specificity in diagnosing the ischemia stroke were 96.4% and 98.8% within 7 days after onset. Of all the cases, 62.1% were associated with the cerebral large-vessel disease and emboligenic heart disease. Only 36.2% had a classic lacunar syndrome but 69.0% had more frequently an abrupt onset of symptoms. Conclusion DWI is of high accuracy for diagnosing centrum ovale infarction and detecting early infarction lesions which are difficult to be displayed in conventional MRI, and very helpful in differentiating the acute from non-acute lesions; symptomatic centrum ovale infarction is suggested to be associated with large-vessel and heart disease which should be distinguished from the lacunar infarcts.