弥散加权成像在脑干梗塞中的应用价值

目的　探讨弥散加权成像 (DWI)在脑干梗塞中的应用价值。方法　 2 0例脑干梗塞患者 ,中脑 3例 ,桥脑 8例 ,延脑 4例 ,脑干多发梗塞 5例 ,同时合并其它脑内梗塞或陈旧梗塞者占 15例 ,其中超急性 (<6h) 1例 ,急性 (6h～ 3d) 10例 ,亚急性 (3～ 7d) 7例 ,慢性期 2例 ,全部行常规DWI扫描。结果　全部成功行DWI检查 ,其中超急性期 1例仅在DWI明确显示梗塞病灶 ,急性期DWI显示病灶对比更加清晰 ,部分病变范围较T2 WI扩大 ,亚急性期DWI显示病灶仍呈较高信号 ,范围与T2 WI相仿或略小 ,陈旧梗塞软化灶DWI显示为低信号。延髓梗塞灶相对局限 ,边缘清楚 ,信号对比强 ,其中小脑后下动脉梗塞灶定位特征明显。桥脑和中脑梗塞灶急性期边缘较模糊 ,以桥臂连接部更加明显。结论　DWI可以早期特异地发现脑干梗塞灶 ,明确病灶范围和新鲜程度

The Value of MR Diffusion Weighted Image in Brainstem Infarction

Objective To discuss the application value of diffusion weighted image(DWI)in brainstem infarction.Methods 20 cases of brainstem infarction included 3 cases of midbrain,8 cases of pons and 4 cases of medulla and 5 cases of multi infarction of brainstem.15 cases of them are accompanied with infarction of other location.All cases were performed DWI examination including of 1 case in super acute stage,10 cases in acute stage,7 cases in sub-acute stage and 2 cases in chronic stage.Results All cases were successfully performed DWI.The lesion of super acute can be definitely displayed in DWI while it can not be displayed clearly in T 2WI. DWI signals of acute and sub-acute infarction were higher than that of T 2WI/FLAIR.The area of lesion displayed by DWI and T 2WI was not always the same.The chronic lesion showed low signal in DWI.The lesion of medulla infarction seems to be limited and clear edge with high contrast signal.The lesion of posterior inferior cerebellar artery infarction with wallenberg syndrome can be characterized displayed by MRI,especially detected by DWI.The lesions of pons and midbrain were often larger than that of medulla with blur edge.Conclusion DWI can help detect early lesion of brainstem infarction and demonstrate the area and stage of lesion.