Propeller弥散加权成像技术在诊断急性脑梗塞中的应用

目的:探讨Propeller弥散加权成像技术在诊断急性脑梗塞中的应用价值。材料和方法:临床怀疑急性脑梗塞的123例患者,分别用Propeller DWI和常规EPI DWI做头颅MRI检查。由两名医师和一名技师共同读片并评价图像伪影和急性脑梗塞。对临床表现和病灶部位符合,DWI图像为高信号,相应部位ADC值降低,诊断为急性脑梗塞。结果:123例中,常规EPI DWI在颞叶、额叶、脑干和小脑出现伪影,分别为91例、43例、5例和7例;12例金属伪影。Propeller DWI在颞叶、额叶出现伪影,分别为2例和1例;无金属伪影。Propeller DWI检出全部77个急性脑梗塞灶,常规EPIDWI检出68个,漏诊9个。结论:Propeller DWI能够消除磁敏感性伪影,改善图像质量,提高病灶的检出率。

Improved Imaging Quality and Detection of Acute Cerebral Infarction with PROPELLER Diffusion Weighted MR Imaging

Purpose: To assess the value of propeller diffusion weighted imaging in defecting acute cerebral infarction lesions. Materials and Methods: One hundred twenty three patients who were suspected of having acute cerebral infarction underwent PROPELLER diffusion-weighted imaging and echo-planar diffusion-weighted imaging. Two radiologists and one technician compared these images for presence of artifacts, visualization of infarction lesions. Diagnosis criteria of acute cerebral infarction lesion: clinical symptom and imaging display is identical, high signal on diffusion weighted imaging, and low apparent diffusion coeffcient value. Results: PROPELLER diffusion-weighted imaging reduced susceptibility artifact. In the temporal lobes, frontal lobes, brainstem and cerebellum, with echo-planar diffusion-weighted imaging, artifacts were present in 55, 33, 5 and 7 subjects of 123, respectively. Metallic artifact was present in 12 of 123. With PROPELLER diffusion-weighted imaging, in temporal lobes, frontal lobes, artifacts were present in 2, 1 of 123, respectively. No metallic artifact. Seventy-seven lesions of acute cerebral infarction were diagnosed with PROPELLER diffusion-weighted imaging. 68 of 77 lesions were diagnosed, 9 lesions were missed with echo-planar diffusion weighted imaging. Conclusion: PROPELLER diffusion weighted imaging dramatically reduced susceptibility artifact, offers better image quality and detects more acute cerebral infarction lesions than echo-planar diffusion weighted imaging.