磁共振快速液体衰减反转恢复序列对亚急性和慢性蛛网膜下腔出血的诊断价值

目的研究ＭＲ快速液体衰减反转恢复（ｆｌｕｉｄａｔｅｎｕａｔｅｄｉｎｖｅｒｓｉｏｎｒｅｃｏｖｅｒｙ，ＦＬＡＩＲ）序列诊断亚急性和慢性蛛网膜下腔出血（ｓｕｂａｒａｃｈｎｏｉｄｈｅｍｏｒｈａｇｅ，ＳＡＨ）的价值。方法３０例头部健康者和１７例次ＳＡＨ患者在发病后第４～３５天进行头部ＭＲＩ检查。扫描机为０．５Ｔ超导ＭＲ机。观察亚急性和慢性ＳＡＨ在ＦＬＡＩＲ的信号表现，并与同期ＣＴ和常规ＭＲＩ所见比较。再对４６个正常和病变的ＦＬＡＩＲ图像做双盲比较分析，以评价其诊断可靠性。结果ＦＬＡＩＲ成像显示亚急性和慢性ＳＡＨ（９４％）明显优于Ｔ１ＷＩ（４１％，Ｐ＜０．０１）和ＣＴ（２７％，Ｐ＜０．０１）。尤其在亚急性期，ＦＬＡＩＲ成像显示率达１００％，与ＣＴ（３３％，Ｐ＜０．０１）相比差异有非常显著性意义。双盲分析结果，无一例假阳性和假阴性诊断。结论快速ＦＬＡＩＲ序列诊断亚急性和慢性ＳＡＨ明显优于ＣＴ和常规ＭＲＩ，应作为本病检查的常规方法

Diagnostic evaluation of subacute and chronic subarachnoid hemorrhage with MRI using turbo fluid attenuated inversion recovery pulse sequence

Objective To study the role of turbo fluid attenuated inversion recovery (FLAIR) pulse sequence MR imaging in diagnosing subacute and chronic subarachnoid hemorrhage (SAH). Methods The turbo FLAIR images of 30 healthy brains and 17 patients with SAH 4-35 days after the ictus were obtained at T5NT 0.5 T superconductivity MR scanner. The findings of subacute and chronic SAH on FLAIR images were compared with the findings on conventional spinecho MRI and CT images, then, a blind study of the fortysix FLAIR images was performed to verify the reliability of the comparative evaluation. Results The visualization of SAH on CT and MRI depended partly on the time after the ictus. In visualization of subacute and chronic SAH, FLAIR(94% detection) was significantly superior to T1WI(41%, P<0.01) and CT(27%, P<0.01). FLAIR detected all the subacute SAH(100%), whereas T1WI and CT detected 42%(P<0.01) and 33%(P<0.01), respectively. In a blind comparative study, no falsepositive or falsenegative identification was made. Conclusions Turbo FLAIR MR imaging is a reliable technology to visualize and confirm the subacute and chronic SAH, it is superior to conventional MRI or CT and should be used as a routine method in diagnosing the disease.