MRI及MR扩散成像在评价大脑半球皮质弥漫性病变的价值

目的 探讨MRI及MR扩散成像在评价大脑半球皮质弥漫性病变的价值.方法 收集2006年1月至2009年5月天津市第一中心医院大脑半球弥漫性病变患者19例,其中男9例、女10例,年龄范围16～70岁,平均年龄45岁.所有患者均于Philips 1.5 T MR扫描机上进行.SE-EPIDWI序列,TR/TE 6225 ms/118.7 ms,ETL 128,FLIP 90°,层厚5 mm,矩阵128×128,b值1000 mm2/s.结果 3例CJD患者,4例聚氯乙烯黏合剂中毒患者,2例病毒性脑炎患者,3例肝衰竭相关的脑水肿患者,1例一氧化碳中毒迟发脑病患者,DWI和ADC均呈高信号,而在随访的MRI研究中,大部分病变恢复较快,DWI高信号消失.4例窒息后昏迷、2例H2S中毒患者的DWI呈高信号,ADC呈低信号.结论 DWI能够更早期敏感的显示大脑半球弥漫性病变的部位和范围,尤其是扩散受限的病变.DWI呈显著高信号,ADC呈低信号,提示细胞毒性水肿.当DWI和ADC均呈高信号时,显示病变的T2效应,提示血管源性水肿.

Abstract：

Objective To study the MRI and DWI appearance of diffuse lesion in the bilateral cerebral hemisphere. Methods 19 patients with diffuse lesion in the cerebral hemisphere were concluded in the study,9 were male and 10 were female. The age range is from 16 to 70 years old and mean age is 45 years old. All of the patients performed MR scan on Philips 1.5 T MRI system. The parameters of SE-EPI DWI sequence,TR/TE 6225/118. 7 ms, ETL 128, FLIP 90°, thickness 5 mm, matrix 128 × 128,b = 1000 mm2/s. Results 3 cases of CJD which showed bilateral diffuse high signal intensity in the cerebral hemisphere on DWI, 4 cases of polyvinyl chloride(PVC) adhesive toxication,2 cases of viral encephalitis,3 cases of liver failure- related brain edema, 1 cases of delayed encephalopathy of CO toxication, all of the lesions showed high signal intensity both on DWI and ADC sequences. On the following MRI, most of the high signal recovered and the high signal disappeared. 4 cases of asphyxia with coma, 2 cases of H2S toxication, The lesion of them showed high signal intensity on DWI and low signal on ADC. Conclusion DWI can sensitively show the lesion with limited diffusion. The patients with high signal intensity on both DWI and ADC indicating T2 effect.

The value of MRI and MR DWI in diffuse lesion of the cerebral hemisphere

Objective To study the MRI and DWI appearance of diffuse lesion in the bilateral cerebral hemisphere. Methods 19 patients with diffuse lesion in the cerebral hemisphere were concluded in the study,9 were male and 10 were female. The age range is from 16 to 70 years old and mean age is 45 years old. All of the patients performed MR scan on Philips 1.5 T MRI system. The parameters of SE-EPI DWI sequence,TR/TE 6225/118. 7 ms, ETL 128, FLIP 90°, thickness 5 mm, matrix 128 × 128,b = 1000 mm2/s. Results 3 cases of CJD which showed bilateral diffuse high signal intensity in the cerebral hemisphere on DWI, 4 cases of polyvinyl chloride(PVC) adhesive toxication,2 cases of viral encephalitis,3 cases of liver failure- related brain edema, 1 cases of delayed encephalopathy of CO toxication, all of the lesions showed high signal intensity both on DWI and ADC sequences. On the following MRI, most of the high signal recovered and the high signal disappeared. 4 cases of asphyxia with coma, 2 cases of H2S toxication, The lesion of them showed high signal intensity on DWI and low signal on ADC. Conclusion DWI can sensitively show the lesion with limited diffusion. The patients with high signal intensity on both DWI and ADC indicating T2 effect.