Gd-DTPA增强MRI对脑梗塞的诊断价值

目的：评价 Ｇｄ － Ｄ Ｔ Ｐ Ａ 在脑梗塞定性诊断中的应用价值。方法：对４０ 例脑梗塞患者进行回顾性分析， 所有病例均行 Ｍ Ｒ 常规平扫及增强扫描，并对增强前后的病变进行定性分析。结果：增强前有１ 例（ ２ ．５ ％ ） 未发现病变，１８ 例（４５ ．０ ％ ） 病变表现不典型，与肿瘤难以鉴别，２１ 例（５ ２ ．５ ％ ） 能够确诊为脑梗塞；增强后１００ ％ 均确诊为脑梗塞。大脑半球的梗塞多呈脑回样强化， 小脑、丘脑、脑干等部位的梗塞则以不规则环行强化及较均匀的点片状强化为主。病变强化的最早时间为１ ｄ ，最晚为１ 年２ 个月。７５ ．８ ％ 病例强化呈逐渐增强趋势。结论： Ｇｄ － Ｄ Ｔ Ｐ Ａ 增强 Ｍ Ｒ 可以提高脑梗塞的确诊率，并能早期发现脑梗塞， 对指导临床治疗有一定积极的意义。

The Value of Gd-DTPA Enhanced MR Imaging in Diagnosing Cerebral Infarction

Objective:To evaluate the effect of Gd-DTPA in diagnosing cerebral infarction.Methods:To analyses retraspectly 40 cases with cerebral infarction.MRI conventional plain and enhanced scans were performend in 40 cases after the ictus and the qualitative analysis was done before and after enhancement.Results:Before enhancement,there were 1 negative case(2.5%) and 18 suspenseel cases(45.0%) which were not easy to be distinguished from tumor.21 cases(52.5%)were exactly diagnosed cerebral infarction.After enhancement all cases (100%)were exactly diagnosed.Most of infarctions in cerebral hemisphere showed gyriform enhancement,but in erebellum,thalam and stem lesions displayed the irregular circular enhancement or even dotted enhancement.The earliest time of enhancement was one day,and the longest is 14 months.Conclusion:Gd-DTPA enhanced MRI can improve the exact diagnosing rate of infarction and detect early infarctions.It has positive value in guiding clinic treatment.