Value of diffusion-weighted magnetic resonanceimaging in the diagnosis of acute ischemic cerebrovascular disease
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摘要:目的 探讨磁共振弥散加权成像(DWI)在急性缺血性脑血管病诊断中的价值。方法 选取急性缺血性脑血管病患者64例。所有患者均接受CT与DWI检查，比较2种检查方式的检查准确率以及对病变灶的检出率。结果 DWI扫描的检查准确率显著高于CT扫描(P < 0.05)。在对急性脑梗死病灶进行检测时, DWI的检出率显著高于常规序列(P < 0.05)。所有患者均表现为DWI高信号，发病时间不足2 h患者的DWI呈现为稍高信号影，表观扩散系数(ADC)图像表现为低信号; 发病时间为2~6 h患者的DWI呈现为高信号影, ADC图像表现为低信号; 发病时间超过6 h患者的DWI呈现为高信号影, ADC图像表现为低信号。结论 磁共振弥散加权成像在急性缺血性脑血管病诊断中的准确率高，可为疾病治疗提供参考。Abstract:Objective To investigate the value of diffusion-weighted magnetic resonance imaging (DWI) in the diagnosis of acute ischemic cerebrovascular disease.Methods A total of 64 patients with acute ischemic cerebrovascular disease were selected. All patients underwent CT and DWI. The accuracy of the two methods and the detection rate of lesions were compared.Results The accuracy of DWI scan was significantly higher than that of CT scan (P < 0.05). The detection rate of DWI in acute cerebral infarction was significantly higher than that of routine sequence (P < 0.05). All patients showed high signal intensity in DWI. The DWI of patients with less than 2 hours of onset showed slightly high signal intensity, and the apparent diffusion coefficient (ADC) image showed low signal intensity. The DWI of patients with 2 to 6 hours of onset showed high signal intensity and ADC image showed low signal intensity. The DWI of patients with more than 6 hours of onset showed high signal intensity, and ADC image showed low signal intensity.Conclusion Diffusion-weighted magnetic resonance imaging has a high accuracy in the diagnosis of acute ischemic cerebrovascular disease, which can provide references for the treatment of the disease.
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表 1 2种检查方式的检查准确率比较[n(%)]
检查方式 阴性
(n=64)短暂性脑缺血发作
(n=30)可逆性缺血性神经功能缺失
(n=22)腔隙梗死
(n=10)完全性卒中
(n=2)CT 26(40.63) 24(80.00) 14(63.64) 0 0 MRI 3(4.69)* 28(93.33)* 21(95.45)* 10(100.00)* 2(100.00)* 与CT比较, *P < 0.05。 
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表 2 MRI不同序列病灶显示情况比较[n(%)]
序列 脑出血
(n=10个)急性脑梗死
(n=26个)动脉瘤
(n=3个)蛛网膜下腔出血
(n=3个)脑微出血
(n=155个)常规序列 10(100.00) 1(3.33) 0 0 0 DWI 10(100.00) 26(100.00)* 1(33.33)* 1(33.33)* 134(86.45)* 与常规序列比较, *P < 0.05。
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