摘要
目的:研究磁敏感加权成像(SWI)和弥散加权成像(SWI-DWI)界定脑卒中缺血半暗带及其与灌注加权成像(PWI)的临床意义。方法:选取医院收治的52例急性缺血性脑卒中患者,采用SWI-DWI、PWI、T1加权成像(T1WI)自旋回波(SE)序列及T2WI快速自旋回波(FSE)序列等,进行多模式头颅磁共振成像(MRI)检查,分别对DWI、SWI及PWI进行阿尔伯特卒中早期CT评分(ASPECTS)。分析比较SWI-DWI的不匹配范围和DWI-PWI不匹配范围,观察SWI序列的扩张静脉替代脑血容量。采用美国国立卫生研究院卒中量表(NIHSS)评分对急性缺血期侧支循环血管显示程度进行spearman相关分析。结果:SWI-DWI和PWI-DWI的ASPECTS评分差值分别为2.46±1.23和2.72±1.49,其不匹配范围接近,差异无统计学意义。扩张静脉等级及患侧脑血容量呈正相关,具有统计学意义(r=0.454,P<0.05)。SWI序列表现血肿中心区均匀片样低信号,四周则环绕不均匀高信号水肿区,且高信号范围随着时间增加而增大;DWI序列表现出血肿中心持续低信号影,四周环绕稍高信号水肿区不断增大。NIHSS评分对侧支循环血管显示程度进行spearman相关分析,具有统计学意义(r=0.579,P<0.05)。结论:SWI-DWI界定卒中急性期缺血半暗带及与灌注加权成像在临床上的应用有很大的优势,能够在早期挽救缺血半暗带,恢复血供,具有临床应用价值。
Objective: To study the clinical significance of susceptibility weighted imaging and diffusion weighted imaging(SWI-DWI) in defining ischemic penumbra in stroke at acute stage and perfusion weighted imaging(PWI). Methods: 52 patients with acute ischemic stroke who admitted to hospital were selected. SWI-DWI, PWI, T1 weighted imaging(T1 WI) spin echo(SE) sequence and T2 WI fast spin echo(FSE) sequence were used to implement multimode cranial magnetic resonance imaging(MRI) examination, and Alberta stroke program early CT score(ASPECT) was used to evaluate DWI, SWI and PWI. The mismatch ranges between SWI-DWI and DWI-PWI were analyzed and compared, and the observation of SWI sequence on dilated vein was used to replace cerebral blood volume. And the national institutes of health stroke scale(NIHSS) was adopted to evaluate the display degree of collateral circulation at acute ischemic stage, and then the Spearman correlation analysis was used to analyze the degree. Results: The difference values of ASPECTS score of SWI-DWI and PWI-DWI were(2.46±1.23) and(2.72±1.49) respectively, and the mismatch range of them was similar, and the difference of that was not statistically significant. There was a significantly positive correlation between the grade of dilated vein and cerebral blood volume of the affected side(r=0.454, P<0.05). SWI sequence showed that the central region of the hematoma was homogeneous with low signal intensity, and the surrounding region was surrounded by edema region with unevenly high signal, and the range with high signal enlarged with the increasing of time. DWI sequence showed there was shadow with continuous low signal in the center of hematoma, and edema region with surrounding slightly high signal constantly increased. The results of Spearman correlation analysis indicated that there was statistically significance of the correlation between NIHSS score and blood vessel of collateral circulation(r=0.579, P<0.05). Conclusion: The application of SWI-DWI in defining ischemic penumbra in stroke at acute stage and PWI has great advantages in clinical practice, which can rescue ischemic penumbra in early stage and restore blood supply. It has clinical application value.
作者
朱晨
邓才洪
赵洪鉴
谢文
王田
宋轶仁
ZHU Chen;DENG Cai-hong;ZHAO Hong-jian(Department of Neurology,Affiliated Hospital of Chengdu University,Chengdu 610106,China;不详)
出处
《中国医学装备》
2020年第9期64-68,共5页
China Medical Equipment
