DWI及MRA在大面积脑梗塞早期诊断中的价值

目的:评价弥散加权磁共振成像DWI和磁共振血管成像MRA对早期大面积脑梗塞的诊断价值。方法:对24例早期大面积脑梗塞的临床和磁共振资料进行分析,全部患者均行DWI及MRA检查。结果:24例早期大面积脑梗塞中,13例急性期CT扫描未检测出确切病灶,DWI扫描全部出现大片异常高信号,病灶检出率为100％。而在常规T2WI检查中,7例为阴性,病灶检出率为69％。MRA发现血管异常24例,表现为供血动脉闭塞,狭窄、硬化。结论: DWI有助于明确早期大面积脑梗塞病变范围,且能区别新旧病灶。MRA能直接显示大面积脑梗塞闭塞的供血脑血管,联合使用DWI和MRA对早期大面积脑梗塞诊断有重要的临床价值,也有利于早期合理的治疗方案制定及预后判断。

MRI and MRA diagnosis of large area cerebral infarction

Objective:To investigate diagnosific value of conventional MRI(cMRI),diffussion weighted imaging(DWI) and MR angiography(MRA) in the large area cerebral infarction.Methods:24 cases who were diagnosed as large area cerebral in- farction.After the onset of symptom were examined by MR imaging.These squence inclueded T1WI T2WI DWI and MRA.Results:13 cases were found no lesions on the conventional CT.100% hyperintensity was demonstrated on DWI at all ischemic lesions.7 case were found no hyperintense lesions in T2WI.24 cases were found the artery supplying the lesion on the MRA.Conclusion:DWI have more sensitivity and specificity than MRI in diagnosis of the large area cerebral infarction.MRA can directly demonstrated the distribution and degree of occlusive artery.Combination T1WI/T2WI/ DWI and MRA can rapidly and accurately diagnose the acute large area cerebral infarction.It also can provide more infor- mation and better strategies for patients with acute large area cerebral infarction.