摘要
目的探讨增强梯度回波T2*加权血管成像(enhanced gradient echo T2*-weighted angiography,ESWAN)序列在诊断脑梗死伴发脑微出血(cerebral microbleeds,CMBs)中不同影像学表现的价值。方法收集2011年3-10月于我院检查诊断脑梗死的55例患者的影像学资料,记录ESWAN图像上CMBs发生部位、数目、表现。结果 55例患者中,ESWAN共检出CMBs患者占52.73%(29/55),高于MRI常规序列检出率(29.09%,16/55)(χ2=6.36,P<0.05),同时行头颅CT平扫的34例患者中,8.82%(3/34)发现梗死灶内少量出血(χ2=29.79,P<0.01)。ESWAN图像上,51.72%(15/29)的患者CMBs的表现为小圆形信号缺失,仅位于梗死灶外,37.93%(11/29)表现为小片状、条状信号缺失,仅位于梗死灶内,10.34%(3/29)梗死灶内外均有CMBs。此29例患者中,37.93%(11/29)为腔隙性脑梗死,其中81.82%(9/11)表现为梗死灶外CMBs;48.28%(14/29)为大面积梗死,其中71.43%(10/14)表现为梗死灶内CMBs。脑梗死不同分期间CMBs的发生差异有统计学意义(P<0.05)。脑梗死存在脑软化灶时更易发生CMBs(P<0.05)。结论 CMBs的出现与血管的损伤程度有关,ESWAN对脑梗死伴CMBs的诊断有重要价值。
study the value of enhanced gradient echo T2＊-weighted angiography （ESWAN） sequence in the diagnosis of cerebral infarction accompanying cerebral microbleeds. Methods Imaging data were collected from 55 patients admitted to our hospital from March to October in 2011 and diagnosed with cerebral infarction. The site, number, and manifestations of cerebral microbleeds on ESWAN were recorded. Results The proportion of detected cerebral microbleeds was 52.73% （29/55）, 29.09% （ 16/55 ）, and 8.82% （3/34） respectively on ESWAN, conventional MR sequences （ Chi square = 6.36, P 〈 0.05） , and CT scanning （Chi square = 29.79, P 〈 0.01 ）. In the ESWAN images, there were 51.72% patients （15/29） manifesting as absence of small round signals only outside of the infarct, 37.93% （11/29） as absence of small sheet and strip signals only in the infarct, and the left 10.34% （3/29） as above-mentioned signals in and outside of the infarct. Of the 29 patients with cerebral microbleeds detected in and outside the infarct, 37.93% （11/29） were diagnosed as lacunar infarction with 81.82% （9/11） of them diagnosed as cerebral microbleeds outside the infarct, 48.28% （14/29） were diagnosed as massive cerebral infarction with 71.43% （10/14） of them diagnosed as cerebral microbleeds inside the infarct. The incidence of cerebral mi- crobleeds was significantly different in different stages of cerebral infarction （P 〈 0.05 ）. Cerebral microbleeds were more common when encephalomalacia loci were found following cerebral infarction （ P 〈 0.05 ）. Conclu- sion The occurrence of cerebral microbleeds is closely related with the severity of vascular injury and ESWAN is of great value for the diagnosis of cerebral infarction accompanying cerebral microbleeds.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2012年第19期1998-2001,共4页
Journal of Third Military Medical University
关键词
脑微出血
增强梯度回波T2加权血管成像
磁共振成像
cerebral microbleeds
enhanced gradient echo T2＊ weighted angiography
magnetic reso-nance imaging
