FLAIR、DWI联合MRA在脑梗死中的应用研究

目的:比较常规磁共振成像(T2WI、T1WI)、液体衰减反转恢复成像(FLAIR)、磁共振弥散加权成像(DWI)和磁共振血管成像(MRA)对早期脑梗死的价值。方法:72例早期脑梗死患者,包括超急性期23例,急性期49例。全部患者行脑常规MRI、FLAIR、DWI和3D-TOF-MRA检查。结果:23例超急性期脑梗死的DWI、常规MRI、FLAIR和3D-TOF-MRA的阳性检出率分别为100%、0%、39.1%和78.2%;49例急性期脑梗死的DWI、常规MRI、FLAIR和3D-TOF-MRA阳性检出率分别为100.0%、83.7%、91.8%和80.0%。DWI扫描发现脑梗死发病<6小时、6~24小时、24~72小时病灶ADC值分别为0.34±0.03、0.41±0.03、0.45±0.04,与对侧正常脑组织ADC比较有显著性差异(P<0.05)。结论:在早期尤其是超急性期脑梗死诊断方面,DWI优于常规MRI、FLAIR和3D-TOF-MRA;FLAIR优于常规MRI,对皮层和脑室旁病灶显示更佳;FLAIR、DWI联合MRA能够提供更丰富的诊断信息。

The Applied Research of FLAIR and DWI Combine with MRA in Cerebral Infarction

Objective： To compare the clinical value of conventional magnetic resonance imaging（T2WI, T1WI）, fluid attenuated inversion recovery imaging（FLAIR）, magnetic resonance diffusion-weighted imaging（DWI） and magnetic resonance angiography（MRA） in diagnosing early cerebral infarction. Methods： 72 cerebral infarction patients, of which 23 patients with hyperacute, acute in 49 cases. All patients underwent conventional brain MRI, FLAIR, DWI and 3D-TOF-MRA examination. Results： The positive detection rate of DWI, conventional MRI, FLAIR and 3D-TOF-MRA in 23 hyperacute cerebral infarction patients was 100%, 0%, 39.1% and 78.2%, respectively; The positive detection rate of DWI, conventional MRI,FLAIR and 3D-TOF-MRA in 49 acute cerebral infarction was 100.0%, 83.7%, 91.8% and 80.0% ,respectively. Cerebral infarction in 6 hours, 6 to 24 hours, 24 to 72 hours, the ADC values of DWl lesion were 0.34 ± 0.03,0.41 ± 0.03,0.45±0.04,respectively ,Juxtapose to normal brain tissue ,have a significantly difference （P 〈0.05）. Conclusion： Especially in the early diagnosis of hyperacute cerebral infarction, DWI is superior to conventional MRI, FLAIR and 3D-TOF-MRA; FLAIR is superior to conventional MRI, showed better on the cortex and periventricular lesions; FLAIR and DWI combined with MRA can provide more diagnostic information.