SWAN序列检测点状短T2信号在老年腔隙性脑梗塞患者中的应用

目的：探讨重度T2*加权成像（SWAN）技术对老年腔隙性脑梗塞伴点状短T2信号患者的临床应用价值。方法：收集我院60岁以上老年腔隙性脑梗塞患者58例为腔隙性脑梗塞组，同时收集同期58例健康老年人作为对照组。两组116例均行轴位GRE-T2*WI及SWAN序列检查。分别记录两个序列点状短T2信号的发生例数、部位、数目及腔隙性脑梗塞病灶的部位和数目。结果：所有116例中SWAN序列发现点状短T2信号31例77处，GRE-T2*WI序列发现17例38处。腔隙性脑梗塞组中25例（43.1%）发现点状短T2信号，正常对照组为6例（10.3%）。腔隙性脑梗塞组中点状短T2信号病变轻、中、重度均可见，正常对照组仅见轻度点状短T2信号。不论点状短T2信号的发生率还是分级，腔隙性脑梗塞组与正常对照组均有明显差异。结论：SWAN序列检出点状短T2信号优于GRE-T2*WI序列。点状短T2信号大多被认为是脑微出血的表现形式，在老年腔隙性脑梗塞组中有较高的发生率，与腔隙性脑梗塞的数目呈正相关。对老年腔隙性脑梗塞病人溶栓治疗时要充分考虑点状短T2信号因素，必要时加做SWAN序列，指导并改进临床治疗方案。

Application of T2-star weighted angiography detecting point-like short-T2 signal among the aged with lacunar infarction

Objective： To explore the clinical application of T2-star weighted angiography （SWAN） in deteeting lacunar infarction in aged patiens with point-like short-T2 signal, Methods： Fifty-eight cases with lacunar infarctinn and 58 cases healthy elderly population above 60-years old as control group were examined using SWAN and GRE-T2＊WI sequence. The number, location and occurrence of point-like short-T2 signal and location, and number of lacunar infarction were calculated. Result： Seventy-seven point-like short-T2 signal in 33 cases were demonstrated by SWAN and 38 point-like short-T2 signal in 17 cases were found by GRE-T2＊WI sequence, including 25 cases of lacunar infarction group and 6 cases of control group. Slight, moderate, severe degree of point-like short-T2 signal were fbund in lacunar infarction group. Only slight point- like short-T2 signal were seen in control group. Incidence and grade of point-like short-T2 signal were significantly different in the two groups. Conclusion： SWAN sequence was much better than GRE-T2＊WI in the sensitivity to show point-like short-T2 signal. Most point-like short-T2 signal was considered as cerebral microbleeds. It was revealed that the occurrence of point-like shon-T2 signal was significantly high in lacunar infarction patients. Enough attention shouhl be paid to those pointlike short-T2 signal if necessary SWAN sequence should be performed before thrombolystic therapy, so this may guide and improve the clinical treatment plan.