标题:磁共振弥散加权成像在超急性期脑梗塞诊断中的临床应用
作者:刘清波 1,李润霞 1,王慧 2 榆林市中医医院磁共振室 1、放射科 2,陕西 榆林 719000
卷次:
2019年30卷9期
【摘要】 目的 探讨磁共振(MRI)弥散加权成像(DWI)在超急性期脑梗塞诊断中的应用价值。方法 回顾性分析2017年1月至2018年1月榆林市中医医院诊治的30例急性脑梗塞患者的临床资料,所有患者入院后均行急诊MRI常规和DWI扫描,对比常规MRI、DWI对超急性期脑梗塞检出率、相对表观弥散系数的差异,分析DWI对超急性期脑梗塞的诊断价值。结果 经临床确诊超急性脑梗塞20例,急性脑梗塞10例。超急性期脑梗塞患者DWI图像表现为单发或多发异常高信号,T2W1、T1W1、FLAIR等信号;超急性期脑梗塞及急性期脑梗塞患者的患侧表观弥散系数、健侧表观弥散系数、相对表观弥散系数分别为[(0.96±0.13)% vs (0.72±0.01)%]、[(0.39±0.02)% vs (0.33±0.01)%]、[(56.02±2.36)%vs (42.15±1.75)%],超急性期脑梗塞均明显高于急性期脑梗塞,差异均有统计学意义(P<0.05)。常规MRI诊断超急性期脑梗塞的灵敏度、特异度为55.00%、100.00%,DWI诊断超急性期脑梗塞的灵敏度、特异度为95.00%、100.00%;DWI鉴别诊断脑梗塞准确率为96.67%,明显高于常规MRI的70.00%,差异有显著统计学意义(P<0.01)。结论 磁共振DWI可准确显示超急性期脑梗塞病灶,诊断超急性期脑梗塞准确率高于常规MRI。
【关键词】 磁共振;弥散加权成像;超急性期脑梗塞;脑梗塞;诊断
【中图分类号】 R743.33 【文献标识码】 A 【文章编号】 1003—6350(2019)09—1176—03
Clinical application of diffusion-weighted magnetic resonance imaging in the diagnosis of hyperacute cerebralinfarction.
LIU Qing-bo 1, LI Run-xia 1, WANG Hui 2. Magnetic Resonance Room 1, Department of Radiology 2, YulinTraditional Chinese Medicine Hospital, Yulin 719000, Shaanxi, CHINA
【Abstract】 Objective To investigate the value of diffusion weighted imaging (DWI) in the diagnosis of hyper-acute cerebral infarction. Methods The clinical data of 30 patients with cerebral infarction treated in Yulin TraditionalChinese Medicine Hospital from January 2017 to January 2018 were retrospectively analyzed. All patients underwentemergency conventional MRI and DWI scanning after admission. The detection rate, and relative apparent diffusion coef-ficient of conventional MRI and DWI for hyperacute cerebral infarction were compared, and the diagnostic value ofDWI for hyperacute cerebral infarction was analyzed. Results Twenty cases of hyperacute cerebral infarction and 10cases of acute cerebral infarction were clinically diagnosed. The DWI images of patients with hyperacute cerebral infarc-tion showed single or multiple abnormal high signals, such as T2W1, T1W1, FLAIR. The apparent diffusion coefficientof the affected side, the apparent diffusion coefficient of the healthy side, and the relative apparent diffusion coefficientof the patients with hyperacute cerebral infarction versus patients with acute cerebral infarction were (0.96±0.13)% vs(0.72±0.01)%, (0.39±0.02)% vs (0.33±0.01)%, (56.02±2.36)% vs (42.15±1.75)%, respectively, all with statistically signif-icant difference (P<0.05). The sensitivity and specificity of conventional MRI in the diagnosis of hyperacute cerebral in-farction were 55.00% and 100.00%, and those of DWI were 95.00% and 100.00%. The accuracy of differential diagnosisof cerebral infarction by DWI (96.67%) was significantly higher than that by conventional MRI (70.00%), P<0.01.Conclusion DWI can accurately display the hyperacute cerebral infarction lesions, with higher accuracy rate in diag-nosing hyperacute cerebral infarction than conventional MRI.
【Key words】 Magnetic resonance imaging (MRI); Diffusion weighted imaging (DWI); Hyperacute cerebral in-farction; Cerebral infarction; Diagnosis
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