摘要
目的:弥散加权MRI(DW1)因能够在早期、快速、敏感地反映出脑部缺血性病变而成为脑梗塞患者急性期诊断不可缺少的重要的检查方法,但是对于某些部位的某些小的病灶在急性期DW1有时亦不能查出。本研究以脑干梗塞的患者为对象,对急性期DW1的敏感度进一步探讨。方法:以发病24小时以内施行DWI检查的28例患者作为对象;DWI是在1.5Tesl的MR装置下,采用断层回波成像的,与此同时,还进行了T2加权MRI及水抑制成像FLAIR(fluidattenuated inversion recovery)的检查,最终梗塞灶根据平均127小时后的以上所述的MRI检查中的所见及临床症状来综合判断的,只把明确的高信号区域判断为病灶。结果:最终梗塞灶为中脑2例,桥脑9例,延髓17例。通过第一次DWI,检查出病灶的16例(敏感度57.1％),没有明确检查出病灶的12例,其中在这12例患者中有11例是在以后的MRI检查中发现为延髓病变,有1例确认为桥脑病变。从发病开始到施行DWI检查为止,时间越短,病变越不容易查出。结论:应该注意在急性期的DWI中即使没有明确的病灶,也不能否认脑干梗塞,特别是延髓梗塞。
Objective: Diffusion - weighted magnetic resonance imaging (DWI) provides one of the earlist demonstrations of ischemic lesions. However,some lesions may be missed in the acute stage due to technical limitation of DWI. We therefore conducted the study to clarify the sensitivity of DWI to acute brain stem infarctions. Methods: Twenty -eight patients with the final diagnosis of brainstem infarction who had been examined by DWI within 24 hours of onset were retrospectively analyzed for demonstrating the sensitivity of initial DWI diagnoing the final ischemic lesion. Only obvious hyperintensity on DWI was regarded to show an ischemic lesion. Results: Sixteen(57. 1%)out of 28 patients had brain stem infarctions demonstrated by initial DWI. In the remaining 12 cases, no obvious ischemic lesions was evident on initial DWI. Subsequent MRI stuies obtained 127 hours;on average after the onset showed infarction in the medular oblongata in 11 cases and in the pons in one case. Conclusions: Negative findings of DWI in the acute stage does not exclude possibility of the brain stem infarction,in particulary medulla oblongata infaretion.
出处
《脑与神经疾病杂志》
2003年第5期297-299,301,共4页
Journal of Brain and Nervous Diseases
关键词
脑干梗塞
急性期
弥散加权MRI
影像学诊断
延髓梗塞
Acute stroke Cerebral infarction Brain stem infarction diffusion -weighted MRI(DW1)
