3.0T MRI磁敏感加权成像在老年人急性脑梗死伴出血的诊断价值

摘要

目的 探讨3.0T MRI磁敏感加权成像在老年人急性脑梗死伴出血的诊断价值.方法 对128例疑似急性脑梗死的老年患者全部进行常规MRI扫描、弥散加权(DWI)扫描及磁敏感加权(SWI)扫描.结合常规MRI、DWI、SWI检查图像,判断SWI在老年人急性脑梗死伴微出血的观测价值.结果 本组128例临床疑似急性脑梗死的患者中,SWI发现急性脑梗死46例,其中伴出血19例；DWI发现急性脑梗死73例,其中伴出血的13例；常规MRI发现急性脑梗死67例,其中伴出血的12例.按大脑半球、小脑半球、脑干发病部位分类,SWI检出急性脑梗死伴微出血分别为14例、2例、3例；DWI检出急性脑梗死伴微出血分别为11例、1例、1例；常规MRI检出急性脑梗死伴微出血分别为9例、1例、2例.结论 诊断急性脑梗死伴出血,SWI明显优于DWI及常规MRI,对脑干和小脑半球的急性脑梗死伴出血灶,由于接近颅底,SWI序列伪影干扰较大,病变显示效果欠佳.%Objective To investigate the value of 3.0T MRI susceptibility weighted imaging (SWI) in the diagnosis of acute brain infarction with hemorrhage in elderly patients.Methods Patients with suspected acute brain infarction received MRI examination using routine sequences,diffusion-weighted imaging (DWI) and SWI sequences for imaging evaluation of infarction as well as detection of possible micro-hemorrhage.Results Among 128 suspected cases,acute infarction was diagnosed in 67,73 and 46 patients based on routine MRI imaging,DWI and SWI,respectively.Further analysis revealed 12,13 and 19 hemorrhagic lesions in routine MRI imaging,DWI and SWI,respectively.With regard to intracranial distribution,cererbral region predominated.Conclusions For assessment of acute brain infarction with hemorrhage,SWI is more sensitive than DWI and routine MRI.However,the value of SWI is limited in evaluating lesions located in cerebellum and brain stem due to imaging artifacts from skull base.