磁共振弥散加权成像在急性脑梗死诊断中的价值

目的探讨磁共振弥散加权成像对超急性、急性脑梗死的诊断价值。方法对22例疑似急性期脑梗死患者,行磁共振常规T1WI、T2WI、水抑制序列(FLAIR)、弥散加权扫描(DWI)。测定梗死灶ADC值,同时测定对侧相应部分正常脑组织ADC值。结果 22例中,超急性期脑梗死3例,急性期19例,超急性期、急性期脑梗死在DWI上表现为高信号,T2WI上为等信号或部分稍高信号,ADC图上表现为低信号。病灶ADC值较对侧相应区域明显下降,梗死灶ADC值与对侧相应部位正常脑组织ADC值差异有意义(P0.05)。结论磁共振弥散成像对超急性期、急性期脑梗死病变较常规MRI敏感,DWI有助于多发脑梗死中新旧病灶的区分,为临床选择治疗方案提供影像学依据。

Diagnostic value of diffusion weighted magnetic resonance imaging in acute cerebral infarction

Objective To investigate the value of diffusion weighed magnetic resonance imaging（MRI） in the diagnosis of superacute and acute cerebral infarction.Methods Twenty-two cases of suspected superacute and acute cerebral infarction were scanned using conventional MRI T1WI,T2WI,FLAIR and DWI（diffusion weighed imaging）.The ADC of each stage lesion and corresponding contralateral brain tissue were calculated.Results In the 22 cases,there were 3 superacutes,19 acutes.Superacute and acute cerebral infarction appeared as the areas of high intensity on DWI,normal or slightly high intensity on T2WI,and low intensity on ADC mapping.The ADC of lesion was significantly depressed compared with that of contralateral tissue.There was positive correlation between infarct lesion and corresponding contralateral normal brain tissue（P0.05）.Conclusion Compared with conventional MRI,diffusion weighed MRI is sensitive to superacute and acute cerebral infarction.In multiinfarcted lesions,DWI assists to distinguish new or old lesion in polyinfarction,which contributes to providing the basis for the clinical treatment programs.