依达拉奉治疗急性脑梗死后脑水肿的MRI动态观察

目的通过MRI各项指标观察依达拉奉钠对急性脑梗死后脑水肿影响。方法将60例急性脑梗死患者随机分成对照组30例和治疗组30例，对照组予以脑梗死常规治疗，治疗组在常规治疗基础上加用依达拉奉，在脑梗死后1，5，14d行MRI扫描，扫描后工作站后处理合成ADC图，测量、计算脑梗死体积、水肿吸收率（△V）、各序列的信号强度比（SIR）、信号强度比相对变化率（ASIR）、相对ADC（rADC）。结果脑梗死后14d，治疗组的脑梗死体积明显小于对照组，差异具有统计学意义（P〈0．01）；治疗组的△V明显高于对照组，差异具有统计学意义（P〈0．05）。脑梗死后5d和14d，治疗组T1wI的sIR均明显高于对照组，差异具有统计学意义（P〈0．01），T2WI、FLAIR序列的ASIR均明显低于对照组，差异具有统计学意义（P〈0．05）。脑梗死后5d，治疗组DwI序列的SIR明显低于对照组，差异具有统计学意义（P〈0．01）。治疗组T1wI、T2wI、FLAIR序列的△sIR均明显高于对照组，差异具有统计学意义（P〈0．05）。梗死后5d，治疗组梗死区rADC明显高于对照组，差异具有统计学意义（P〈0．01）。结论依达拉奉对缺血性脑水肿有明显的抑制作用。

MRI dynamic observation of edaravone in treatment of cerebral edema after acute cerebral infarction

Objective To evaluate the effect of edaravone with MRI indicators on cerebral edema after acute cerebral infarction. Methods Sixty cases of acute cerebral infarction were randomly divided into control group （30 cases） and treatment group （30 cases）. The control group was given routine treatment of cerebral infarction. The treatment group was treated with edaravone on the basis of conven- tional treatment. MRI scan were performed at ld, 5d and 14d after cerebral infarction. ADC graph were processed and synthesized through workstation. Cerebral infarction volume, edema absorption rate（AV） and signal intensity ratio（SIR）of each sequence, signal intensity ratio relative change rate（ASIR）and rel- ative apparent diffusion coefficient （rADC） were measured and calculated. Results Cerebral infarction volume of treatment group was smaller than that of control group （P 〈 0.01）, and AV was higher than that of control group at 14 d after cerebral infarction （P〈0.05）. At 5 d and 14 d, SIR of TlWI in treat- ment group were significantly higher than in control group （P 〈 0.01） and SIR of T2W and FLAIR were significantly lower than that of control group （P〈 0.05 - 0.01）. At 5d, SIR of DWI in treatment group was lower compared to the control group （P 〈 0.01）. /kSIR of T1WI, TzWI and FLAIR in treatment group were higher than in control group （P 〈 0.05）. The rADC of infarction region of treatment group was higher than that of control group at 5 d （P 〈0.01）. Conclusions Edaravone has obvious inhibitory effect on ischemic cerebral edema.