SWI在早期脑出血及出血性脑梗死的应用价值

目的:探讨磁共振磁敏感加权成像(SWI)对超急性期脑出血和急性出血性脑梗死的诊断价值。方法:收集我院2010年2月～2011年11月超急性期脑出血患者25例,平均年龄58岁,发病时间均在6h以内;急性出血性脑梗死患者22例,平均年龄54岁,发病时间在24h以内。磁共振检查采用GESigna1.5THDMR系统,头颅8通道线圈。行常规T1WI、T2WI、FLAIR、DWI序列扫描,每个病例均加扫SWI序列。结果:25例脑出血病例中20例在T2WI上病灶周边可见到低信号环,显示率为80%。T1WI、T2FLAIR及DWI序列无特征表现提示出血。在SWI上均可见到低信号,显示率为100%,且显示的范围更大、更明显;22例出血性脑梗死病例中2例在T1WI内可见到轻微高信号,显示率约为9%。T2WI、T2FLAIR及DWI序列对出血性脑梗死没有特征性表现。SWI序列显示22例梗死区内均可见点片状不均匀低信号,显示率达到100%。结论:SWI序列较常规MRI序列对诊断早期脑卒中的类型和及早检测出脑梗死出血性转化有更大帮助,对临床治疗有重要指导意义。

The Application Value of Susceptibility Weighted Imaging in Patients with Early Intracerebral Hemorrhage and Hemorrhagic infarction

Objective:To evaluate the application value of susceptibility weighted imaging(SWI)at 1.5 Tesla(t) MRI in patients with hyper acute intracerebral hemorrhage(ICH)and hemorrhagic infarction(HI).Method: Collected twenty-five patients(average age:58)with hyper acute ICH and twenty-two patients(average age:54) with acute HI from 2010.2 to 2011.11.All cases underwent T1WI,T2WI,FLAIR,DWI and SWI scan with 1.5t MRI scanner(GE Signa 1.5T EXCITE HDMR).ICH times of accident are in 6 hour,HI times of accident are in 24 hour.Results:The display rate of intracerebral hematomas was 80%(20/25 cases)in T2WI,but was 100% (25/25cases)in SWI.All cases showed the scope of bleeding greater in SWI than conventional sequence.The display rate of hemorrhagic infarction was 9%(2/22cases)in T1WI,but was 100%(22/22 cases)in SWI. Conclusion:The SWI sequence has greater help in the diagnosis of early stroke type and hemorrhagic infarction than conventional MR sequences.SWI has great guide significance for clinician treatment.