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腔隙性脑梗死的磁共振成像磁敏感加权成像临床研究

[Clinical study of susceptibility-weighted magnetic resonance imaging in lacunar cerebral infarction].

作者信息

Zhao De-qiang, Pan Su-yue, Chne Jian-hui, Wang Jing-xin

机构信息

Huiqiao Department, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2010 Apr;30(4):881-3.

Abstract

OBJECTIVE

To evaluate the clinical application of susceptibility-weighted magnetic resonance imaging (SWAN) in lacunar cerebral infarction imaging.

METHODS

Forty-two cases of lacunar cerebral infarction, including 18 complicated by high blood pressure, 4 by type 2 diabetes and 12 by both high blood pressure and type 2 diabetes, underwent examinations with SWAN and conventional MRI sequences (including GRE sequence T(1) and T(2), T(2) gradient echo, T(2) FLAIR, DWI). The imaging data were analyzed in comparison with the clinical data of the patients.

RESULTS

In 23 patients with lacunar cerebral infarction, intracerebral micro-hemorrhage displayed point-like, round and oval low signal on SWAN. A total of 123 lesions were identified, distributing from the cortical, subcortical, basal ganglia, thalamus, brain stem to the cerebellum. The conventional sequences were more sensitive in detecting the majority of lacunar cerebral infarction than SWAN, while the latter showed better performance in displaying cerebral micro-hemorrhage, tiny blood vessels and small vascular malformations as well as other small vascular diseases. SWAN was superior to other sequences in showing lacunar cerebral infarction complicated by cerebral micro-hemorrhages.

CONCLUSION

MRI SWAN can better display lacunar cerebral infarction associated with cerebral micro-hemorrhages and small veins in the infract region. Identification of the micro-hemorrhages in lacunar cerebral infarction can be critical in determining the proper treatments. Patients with lacunar cerebral infarction are likely to have cerebral micro-hemorrhages in close relation to the number of lacunar infarction sites. The cerebral micro-hemorrhages and lacunar cerebral infraction are both signs of micro-vessel damage of the brain.

摘要

目的

评估磁共振成像磁敏感加权成像(SWAN)在腔隙性脑梗死成像中的临床应用。

方法

42例腔隙性脑梗死患者,其中18例合并高血压,4例合并2型糖尿病,12例同时合并高血压和2型糖尿病,接受了SWAN及常规MRI序列(包括GRE序列T(1)和T(2)、T(2)梯度回波、T(2)液体衰减反转恢复序列、弥散加权成像)检查。将成像数据与患者的临床资料进行对比分析。

结果

23例腔隙性脑梗死患者在SWAN上显示脑内微出血呈点状、圆形及椭圆形低信号。共发现123个病灶,分布于皮质、皮质下、基底节、丘脑、脑干及小脑。常规序列在检测大多数腔隙性脑梗死方面比SWAN更敏感,而SWAN在显示脑内微出血、微小血管及小血管畸形等其他小血管疾病方面表现更佳。在显示合并脑内微出血的腔隙性脑梗死方面,SWAN优于其他序列。

结论

MRI的SWAN能更好地显示与脑内微出血及梗死区域小静脉相关的腔隙性脑梗死。识别腔隙性脑梗死中的微出血对于确定恰当治疗至关重要。腔隙性脑梗死患者很可能出现与腔隙梗死部位数量密切相关的脑内微出血。脑内微出血和腔隙性脑梗死均为脑微血管损伤的征象。

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