GRE-T_2~＊ WI在辅助诊断脑淀粉样血管病的应用研究

目的：探讨脑实质出血在CT及磁共振梯度回波（GRE）T2＊WI上的表现及GRE-T2＊WI在辅助诊断脑淀粉样血管病的作用。方法：CT证实为急性脑实质出血的20例患者,分为基底节区出血组和皮质-皮质下出血组,发病48h内行磁共振GRE-T2＊W I检查,并进行简易智能量表（MMSE）评分,对CT及T2＊WI征象、MMSE评分结果以及患者的相关信息进行总结并分析。结果：皮质-皮质下组高血压病患者比例明显低于基底节区组,且其MMSE评分明显高于基底节区组。两组病灶在GRE-T2＊W I上均表现为沿病灶边界清楚的极低信号,或边界清楚的低信号环,内部为略高信号或低信号区内混杂小点、斑片状高信号。两组在各自病灶周边或对侧都可见到多发的点状低信号,但皮质-皮质下组数目明显多于基底节区组。在皮质-皮质下组,有更多的病例出现有多灶出血及复发出血。结论：GRE序列对脑出血的敏感性高,成像快速,对微小动脉的点状出血诊断率明显高于CT。临床及CT检查怀疑脑淀粉样血管病脑出血的患者,可加做磁共振GRE-T2＊W I检查,以进一步提高对其诊断的准确性。

Application of GRE-T2*WI in the supplementary diagnosis of cerebral amyloid angiopathy

Objective：To sum up the cerebral hemorrhage performances on the CT and MR gradient echo（GRE） T2＊ WI,and to discuss the supplementary diagnosis role of GRE-T2＊WI in the cerebral amyloid angiopathy（CAA）.Methods：20 cases who were confirmed acute intracerebral hemorrhage by CT were divided into basal ganglia hemorrhage group and the cortical-subcortical hemorrhage group,and were carried out MR GRE-T2＊ WI inspection and the mini-mental state examination（MMSE） scores in 48 hours after the attack.The CT and T2＊ WI signs,MMSE score results and summary of the patient＇s relevant information were summarized and analyzed.Results：Cortical-subcortical group proportion of patients with hypertension was significantly lower than basal ganglia,and the MMSE score was significantly higher than the basal ganglia group.Parenchymal hemorrhage appeared as homogeneous patchy hypointensity or in homogeneous hypointensity with punctuate hyperintensity on GRE-T2＊WI in two groups.There can be seen several dots patchy in respective or around contralateral lesion in two groups,but the cortex-subcortical group＇s number was more than that of basal ganglia group.In the cortex-subcortical group,there were many more of the cases bleeding and recurrent bleeding lesions.Conclusion：For cerebral hemorrhage,GRE sequences has high sensitivity and fast imaging.And its diagnosis rate of spotting in small arteries was significantly higher than that of CT.The patients whose clinical and CT examination are suspected cerebral hemorrhage cased by CAA could be added to perform MRI GRE-T2 ＊ WI inspection to further improve its diagnostic accuracy.