磁共振弥散加权成像和3D-时飞法血管成像诊断超急性期大面积脑梗死83例
The value of MRI DWI combined with 3D-TOF MRA in the diagnosis of hyperacute massive cerebral infarction in 83 cases
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摘要: 目的:探讨磁共振(MRI)弥散加权成像(DWI)和3D-时飞法(3D-TOF)血管成像(MRA)联合检查在超急性期大面积脑梗死中应用价值。方法:83例超急性期脑梗死病例均行常规MRI、DWI序列及3D-TOF MRA扫描,并根据MRI不同序列对病变进行比较。结果:发病时间2 h的51例和发病时间2~6 h的13例T1WI和T2WI均为正常,发病时间2~6 h的19例T2WI呈稍高信号影。DWI全部显示为高信号。3D-TOF MRA显示动脉狭窄和闭塞78例,其中颈内动脉闭塞7例;大脑中动脉分支闭塞19例;大脑后动脉闭塞10例。结论:DWI可以明确诊断急性期脑梗死及其发病部位,结合3D-TOF技术MRA可快速而准确地显示颅内动脉狭窄或闭塞及其相应的脑梗死。Abstract: Objective: To investigate the clinical value of MRI diffusion weighted imaging( DWI) combined with 3D-TOF magnetic resonance angiography( MRA) in the diagnosis of hyperacute massive cerebral infarction. Methods: Eighty-three cases with acute cerebral infarction were scanned using conventional MRI,DWI sequence and 3D-TOF MRA, the lesions in different sequence MRI were compared and analyzed. Results: The T1WI and T2WI of 51 cases with onset time less than 2 h and 13 cases with onset time between 2 - 6 h were normal. The T2WI of 19 cases with onset time between 2 - 6 h were slightly high signal. All DWI were high signal. The artery stenosis and occlusion in 78 cases were found by 3D-TOF MRA,which included 7 cases of internal carotid artery occlusion, 19 cases of middle cerebral artery occlusion and 10 cases of posterior cerebral artery occlusion. Conclusions: DWI can diagnose acute cerebral infarction and identify its location. DWI combined with 3D-TOF MRA technology can quickly and accurately show the intracranial artery stenosis or occlusion and corresponding cerebral infarction.