实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (1): 37-40.doi: 10.3969/j.issn.1003-9198.2022.01.010

• 临床研究 • 上一篇    下一篇

磁共振PWI联合DWI在老年急性期脑梗死中的应用价值

王娟, 朱止平, 李振玉, 孙长录, 牛永超, 闫瑞芳   

  1. 453000 河南省新乡市,新乡市中心医院(新乡医学院第四临床学院)磁共振室(王娟,李振玉,孙长录,牛永超);
    453100 河南省新乡市,新乡医学院第一附属医院放射科(朱止平);磁共振室(闫瑞芳)
  • 收稿日期:2021-02-22 出版日期:2022-01-20 发布日期:2022-01-25
  • 通讯作者: 闫瑞芳,Email:yrf718@163.com
  • 基金资助:
    河南省医学科技攻关计划项目(201602151)

Application value of combined magnetic resonance PWI and DWI in diagnosis of acute cerebral infarction

WANG Juan, ZHU Zhi-ping, LI Zhen-yu, SUN Chang-lu, NIU Yong-chao, YAN Rui-fang   

  1. WANG Juan, LI Zhen-yu, SUN Chang-lu, NIU Yong-chao. Department of MRI Room, Central Hospital of Xinxiang, the Fourth Clinical College of Xinxiang Medical University, Xinxiang, 453000, China;
    ZHU Zhi-ping. Department of Radiology; YAN Rui-fang. Department of MRI Room, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, China
  • Received:2021-02-22 Online:2022-01-20 Published:2022-01-25

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摘要： 目的 探讨灌注加权成像(PWI)联合弥散加权成像(DWI)对急性期脑梗死的诊断价值。 方法 采用回顾性研究方法,收集56例发病时间1~72 h(其中20例为超急性期脑梗死,发病时间＜6 h;36例为急性期脑梗死,发病时间7~72 h)的老年脑梗死病人的临床及影像资料。所有病人均进行PWI和DWI检查,主要观察指标:患侧脑组织DWI异常区域范围及参数、脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)和达峰时间(TTP),比较PWI、DWI检查所得脑部MR图像的参数差异和异常区域范围差异。 结果 所有病人PWI表现为MTT和TTP延长。超急性期病人CBF降低18例(90.00%),正常2例(10.00%);CBV降低10例(50.00%),正常5例(25.00%),升高5例(25.00%)。急性期病人CBF降低36例(100.00%);CBV降低26例(72.22%),正常5例(13.89%),升高5例(13.89%)。超急性期病人信号异常区域DWI均小于PWI。急性期病人DWI信号异常区域低于PWI 21例,与PWI相等10例,大于PWI 5例。 结论 DWI可显示脑梗死的坏死区域,PWI可显示脑梗死的坏死区域及其周围的缺血半暗带,两者联合运用可明确脑梗死及缺血半暗带范围。

关键词: 磁共振成像, 灌注加权成像, 弥散加权成像, 脑梗死

Abstract: Objective To investigate the application value of perfusion weighted imaging(PWI) combined with diffusion weighted imaging (DWI) in the diagnosis of acute cerebral infarction. Methods The clinical and imaging data of 56 elderly patients with cerebral infarction within 1 h to 72 h after the onset of symptoms were collected by the retrospective study. Twenty patients were in hyperacute phase with time since stroke onset<6 h, and 36 patients were in acute phase with time since stroke onset 7-72 h. All the patients were examined by PWI and DWI. The main items for observation included abnormal regions and parameters of DWI and PWI, such as cerebral blood flow (CBF), cerebral blood volume (CBV), mean transient time (MTT) and time to peak (TTP) in affected brain tissue of cerebral infarction. Results PWI showed that MTT and TTP were prolongated. In hyperacute phase, the level of CBF decreased in 18 cases (90.00%) and remained normal in 2 cases (10.00%); the level of CBV decreased in 10 cases (50.00%), remained normal in 5 cases (25.00%), and increased in 5 cases (25.00%). In acute phase, the level of CBF decreased in 36 cases (100.00%); the level of CBV decreased in 26 cases (72.22%), remained normal in 5 cases (13.89%), and increased in 5 cases (13.89%). DWI in hyperacute phase showed less abnormal signal region than PWI in all cases. In acute phase, there were 21 cases with DWI <PWI, 10 cases with DWI=PWI, and 5 cases with DWI > PWI. Conclusions DWI can show the necrotic area of cerebral infarction, while PWI can show both the necrotic area of cerebral infarction and its surrounding ischemic penumbra. Combined use of DWI and PWI can define the range of cerebral infarction and ischemic penumbra.

Key words: magnetic resonance imaging, perfusion weighted imaging, diffusion weighted imaging, cerebral infarction

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