磁共振DWI及灌注加权成像对不同时期脑梗死临床诊断的应用价值研究

目的分析磁共振DWI及灌注加权成像对不同时期脑梗死临床诊断的应用价值。方法回顾分析本院2017年1月至2019年5月收治的112例脑梗死患者的临床资料;对患者所得图像进行分析,对比不同时期梗死区与健侧对照区ADC值,PWI各灌注参数(rCBV、rCBF、MTT、TTP)表现,以及DWI、PWI在不同分期脑梗死中表现关系。结果不同时期梗死区与健侧对照区ADC值比较差异有统计学意义(P<0.05);在超急性期25例患者中,rCBV、rCBF降低,MTT、TTP升高;急性期44例患者中以rCBV、rCBF降低, MTT、 TTP升高为主;亚急性期33例患者中以rCBV、rCBF正常,MTT、TTP升高为主;慢性期10例患者中均为rCBV、rCBF降低,1例患者MTT、TTP表现为升高,其余为降低。超急性期患者68.00%(17/25)为DWIPEI;亚急性期78.78%(26/33)为DWI=PWI;慢性期患者均表现为DWI=PWI。结论 PWI、DWI序列联合诊断可识别早期梗死病灶,并对患者血流灌注情况进行评价,可鉴别半暗带缺血区,并为不同时期临床诊断和梗死分期提供可靠影像学参考依据。

Application Value of Magnetic Resonance DWI and Perfusion-Weighted Imaging in the Clinical Diagnosis of Cerebral Infarction at Different Stages

Objective To analyze the application value of magnetic resonance DWI and perfusion-weighted imaging in the clinical diagnosis of cerebral infarction at different stages.Methods The clinical data of 112 patients with cerebral infarction admitted to our hospital from January 2017 to May 2019 were retrospectively analyzed.The images obtained from the patients were analyzed.The ADC values in the infarction area and healthy control area at different stages and the perfusion parameters(rCBV,rCBF,MTT,TTP)of PWI were compared,and the relationship between DWI and PWI in cerebral infarction at different stages.Results There were significant differences in ADC values between the infarction area and healthy control area at different stages(P<0.05).In 25 patients in the hyperacute phase,rCBV and rCBF decreased,MTT and TTP increased.In 44 patients in the acute phase,rCBV and rCBF decreased,MTT and TTP increased mainly.In 33 patients in the subacute phase,rCBV and rCBF were normal,MTT and TTP increased mainly.In 10 patients in the chronic phase,rCBV and rCBF decreased,and in 1 patient,MTT and TTP increased,and the rest showed decreasing.In the hyperacute phase,68.00%(17/25)patients showed DWIPEI;in the subacute phase,78.78%(26/33)patients showed DWI=PWI.Patients in the chronic phase showed DWI=PWI.Conclusion The combined diagnosis of PWI and DWI sequences can identify early infarct lesions and evaluate the blood perfusion of patients.It can identify the ischemic penumbra and provide reliable imaging references for different stages of clinical diagnosis and staging of infarction.