磁敏感加权成像在急性缺血性脑梗死检查中的应用价值

摘要

Objective To evaluate the applied values of susceptibility weighted imaging (SWI) in acute ischemic stroke.Methods Totally 40 patients with acute ischemic stroke were included within 72 hours after symptom onset.They adopted multimodal magnetic resonance imaging examination,including regular magnetic resonance imaging sequence (T1WI,T2WI),time of flight MR angiography (TOF-MRA),diffusion weighted imaging (DWI) and susceptibility weighted imaging (SWI).Furthermore,12 of the 40 patients received dynamic susceptibility contrast enhanced perfusion weighted imaging (DSCPWI) examination.Results Of the 40 patients,12 ones had positive results for multiple lesions of cerebral microbleeds (CMBs) by SWI,and the detection rate was 30％.There were 24 patients showed susceptibility vessel sign (SVS) in SWI,and the susceptibility rate was 60％.In the 12 patients received DSC-PWI examination simultaneously,there were 7 cases had the anomaly range by SWI larger than that by DWI while similar to that by DSC-PWI.Conclusion SWI can show SVS and CMBs clearly,estimate ischemic penumbra,know intracranial conditions completely and supply reliable basis for individualized treatment.%目的:探讨磁敏感加权成像(susceptibility weighted imaging,SWI)在急性缺血性脑梗死中的应用价值.方法:发病1～72 h内的40例急性缺血性脑梗死患者行常规MRI序列(T1WI、T2WI)、时间飞跃法磁共振血管成像(time of flight MR angiography,TOF-MRA)、磁共振扩散加权成像(diffusion weighted imaging,DWI)、磁敏感加权成像(susceptibility weighted imaging,SWI)检查,其中12例患者同时行动态磁敏感对比增强灌注成像(dynamic susceptibility contrast enhanced perfusion weighted imaging,DSC-PWI)检查.结果:40例患者中,SWI序列检出12例患者脑微出血灶(cerebral microbleeds,CMBs)呈阳性,阳性率30％,均为多发病灶.24例患者在SWI图像上见磁敏感血管征(susceptibility vessel sign,SVS),敏感性60％.其中12例同时行DSC-PWI检查的患者,7例SWI上异常的范围大于DWI上的异常范围,与DSC-PWI上异常的范围基本相同.结论:SWI可清楚显示磁敏感血管征、微出血灶及评估缺血半暗带(ischemic penumbra,IP),全面了解颅内情况,为个体化治疗提供可靠依据.