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[血肿与0.15T磁共振成像。附100例报告]

[Hematomas and MRI at 0.15 T. Apropos of 100 cases].

作者信息

Cosnard G, Jeanbourquin D, Perfettini C, Blanc A M, Iba Zizen M T, Cabanis E A

出版信息

J Radiol. 1987 May;68(5):319-31.

PMID:3612600
Abstract

One hundred hematomas were examined by magnetic resonance imaging (MRI) at 0.15 T, all explored in SEpT1 and most in SEpT2. The number of cases examined in the acute phase during the first 48 hours was low: 8 cases. At this SEpT1 period the hematoma appears of elevated signal with good muscle contrast but without contrast in hepatic and cerebral parenchyma. In a weighted T2 sequence, the intense signals of cerebral edema and plasma or serum enables detection of the encephalic lesion. Findings from 68 hematomas observed in the subacute or chronic phase suggest that their appearance is pathognomonic with visualization in SEpT1 of a crown of an intense signal at least equal to that of fat. The only difficulty at this period is the discovery of a hematoma within the fat: orbital, retroperitoneal... The collection of a subdural hematoma usually appears homogeneous, the intensity of the signal varying with red cell concentration and time. In the soft tissues, the intensity of signal is a function of concentration of hemoglobin and its derivatives and of volume of serous effusion. Images of 24 hematomas during the sequelae phase confirmed the appearance of a "biochemical shell" without signal in SEpT2 and allowed detection of the hematic contents of an occupying process even after long periods, sometimes after one year.

摘要

对100例血肿进行了0.15T的磁共振成像(MRI)检查,均采用自旋回波T1加权序列(SEpT1)进行扫描,多数还采用了自旋回波T2加权序列(SEpT2)。在最初48小时的急性期进行检查的病例数较少:8例。在这个SEpT1时期,血肿表现为信号增强,与肌肉对比良好,但在肝实质和脑实质中无对比。在T2加权序列中,脑水肿以及血浆或血清的强信号能够检测出脑部病变。对68例在亚急性或慢性期观察到的血肿的研究结果表明,它们的表现具有特征性,在SEpT1上可见至少与脂肪信号强度相当的高强度信号环。这个时期唯一的困难在于发现脂肪内的血肿,如眼眶、腹膜后……硬膜下血肿通常表现为均匀一致,信号强度随红细胞浓度和时间而变化。在软组织中,信号强度是血红蛋白及其衍生物浓度以及浆液渗出量的函数。24例血肿后遗症期的图像证实了在SEpT2上出现无信号的“生化壳”,并且即使在很长时间后,有时甚至在一年后,也能检测到占位性病变的血液成分。

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