扩散加权成像在急性脑干梗塞中的诊断应用

摘要

Objective To explore the diagnostic value of diffusion weighted imaging in hyperacute and acute brainstem infarction. Methods Single shot echo planar DWI sequence and conventional MRI were examined in 43 patients with acute and peracute brainstem infarction, including 4 patients with peracute brainstem infarction, 39 with acute brainstem infarction, 35 with pontine infarction, 3 with brain infarction and 5 with medullary infarction. The patients were observed in the signal diffusion weighted imaging and magnetic resonance imaging in T2WI, FLAIR realization. Results Increased DWI signal was observed in the patients of peracute brainstem infarction, with no ab-normal signal in T2WI, FLAIR. Elevated DWI, T2WI, FLAIR signals were observed in the patients of acute brainstem infarction, and the DWI signal range was greater than that of T2WI, FLAIR. Conclusion DWI is more sensitive than conventional magnetic resonance. DWI positive rates contribute to the diagnosis of super acute brain stem infarction. Suspected patients of acute brainstem infarction or peracute brainstem infarction should especially be examined by DWI, to improve the basis for clinical therapy and the prognosis of the patients.%目的：探讨扩散加权成像在超急性及急性脑干梗塞中的诊断价值。方法采用单次激发平面回波DWI序列和常规磁共振对43例急性及超急性脑干梗塞患者进行检查，其中超急性脑干梗塞患者4例，急性脑干梗塞39例；脑桥梗塞35例，中脑梗塞3例，延髓梗塞5例。观察各期患者在扩散加权成像及常规磁共振中T2WI、FLAIR的信号变化。结果在超急性脑干梗塞患者中DWI信号增高，而T2WI、FLAIR信号未见异常。在急性脑干梗塞患者中DWI、T2WI、FLAIR信号增高，但DWI信号范围较T2WI、FLAIR显示更大。结论 DWI较常规磁共振序列敏感，DWI有助于诊断超急性脑干梗塞的检出率，当怀疑急性脑干梗塞尤其是超急性脑干梗塞时更应行DWI检查。