高血压脑内微出血的3.0TMR诊断研究

目的 探讨高血压患者脑内微出血（Cerebral microbleed CMB）在3.0T MR 的表现,比较和分析其发生率、微出血的出血点数、好发部位及其相关因素.方法 选择年龄在32～60 岁的78 例高血压患者,将其分为有腔隙性脑梗死组（58 例）和无腔隙性脑梗死组（20 例）,所有患者均行磁敏感加权成像（SWI）扫描,并与常规MRI T1WI、T2WI、T2WI-FLAIR 序列进行比较.结果 2 组患者中均有CMB 病灶出现,发生率为34.61%（27/78）;其中腔隙性脑梗死组的发生率为41.38%（24/58）,无腔隙性脑梗死组的发生率为15.0%（3/20）;脑内微出血灶以SWI 显示最多,表现为斑点状、圆形或椭圆形信号缺失,直径2～5 mm,周围没有水肿带;发生部位按多少依次为皮质-皮质下区、基底节、丘脑、小脑及脑干.结论 CMB 的存在提示高血压患者微血管病变的严重程度和继发性出血的可能,对高血压引起的脑卒中患者治疗方法的选择和预后的判断具有重要意义.

3T MRI diagnosis of cerebral micro-bleed from hypertension

Objective To explore the efficacy of 3T MRI for demonstrating hypertensive cerebral micro-bleed （CMB）. Methods 78 hypertensive patients （age range： 32-60 years） with （58） or without （20） lacunar infarction underwent susceptibility weighted imaging（SWI）. The SWI was compared with T~WI,T2WI, and T2WI-FLAIR sequences. Results The incidence of CMB was 41.38% （24/58） and 15.0% （3/20） in the patient groups with and without lacunar infarct respectively. The overall incidence of CMB was 34.61% （27/78）. Of all pulse sequences, the SWI displayed CMB more clearly as round or oval punctuate areas of signal loss with diameter of 2 to 5ram and no surrounding edema. CMB was located mainly in the cortex, subcortex, basal ganglia, thalamus, cerebellum and brainstem. Conclusion The finding of CMB on MRI suggests severe microvascular disease with secondary hemorrhage. It has significant impact on treatment options and prognosis in patients with cerebral infarction.