磁敏感加权成像在大面积脑梗死患者中的应用

目的：探讨磁敏感加权成像（ SWI）在大面积脑梗死患者中的应用价值。方法选取20例诊断明确的大面积脑梗死的患者，给予及时入院（发病48 h内）患者NIHSS评分、SWI检查；未及时入院的患者（发病48 h至6 d）但有CT影像确诊的患者仅给予NIHSS评分。发病1周后，全部患者行SWI及CT检查并再次行NIHSS评分，并与之前的CT或SWI进行对比。结果本组20例患者中，12例（60％）于发病时检测出自发性出血，1周后复查发现17例（85％）有自发性出血。8例未及时入院的患者中3例（37．5％）于发病时行CT检查时隐约可见出血，1周后行SWI检查发现7例（87．5％）出血。经分析，老年人大面积脑梗死后的出血程度与NIHSS评分成正相关（rs ＝0．740，P＝0．0005）。 SWI与CT对大面积脑梗死检测出出血进行分析（P入院时＝0．113，P1周后＜0．05），显示SWI用于大面积脑梗死出血检测要优于CT检查。结论 SWI技术相比于CT在应用于大面积脑梗死后自发性出血的检测更为敏感，对治疗大面积脑梗死患者时出现再灌注损伤提供有力的影像诊断依据。

Applications of susceptibility weighted imaging in patients with massive cerebral infarction

Objective To study the application value of susceptibility weighted imaging ( SWI) in massive cerebral infarction. Methods The head and the clinical manifestation of 20 patients with clear massive cerebral infarction were diagnosed by CT or MRI.Patients with timely admission(48 hours of onset) were treated with NIHSS scores,SWI check.Patients without timely admission(48 hours to 6 days from onset) with CT imaging diagnosis were treated only with the NIHSS score.A week after the incidence,all patients underwent SWI and CT examination and again for the NIHSS score, which was compared with the previous CT or SWI.Results Of the 20 patients, spontaneous bleeding was detected in 12 cases (60%) in the pathogenesis,and it appeared in 17 cases (85%) in reexamination a week later.Faintly visi-ble hemorrhage appeared in 3 patients (37.5%) out of the 8 cases without timely admission in the pathogenesis of CT inspection,and bleed-ing was found in 7 patients (87.5%) underwent SWI examination in the check one week later.The degree of bleeding was positively correla-ted with NIHSS score after old people's extensive cerebral infarction (rs=0.740,P=0.0005).When SWI and CT were use in the detection of hemorrhage in massive cerebral infarction (P =0.113 on admission and after admission,P <0.05) showed that SWI applied in massive cer-ebral infarction hemorrhage detection was superior to CT detection.Conclusion Compared with SWI,CT can more effectively reflect the situ-ation of massive cerebral infarction patients accompanied by bleeding,giving imaging evidence for the treatment of large area cerebral infarc-tion and the reperfusion injury.