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目的探讨自发性脑出血(ICH)与腔隙性脑梗死患者颅内脑微出血(CMBs)MR磁化率的差异,评价磁化率在预测CMBs风险性中的可行性。方法搜集颅内存在CMBs的ICH和/或腔隙性脑梗死患者83例,其中ICH组34例,腔隙性脑梗死组49例。所有患者均采用3.0 T MR快速多回波T2*梯度成像序列,通过场到源的反演计算得到可定量的磁量图,逐个分析CMBs灶的信号特征并测量其直径及磁化率。采用t检验对比分析ICH组与腔隙性脑梗死(腔梗)组之间CMBs灶直径、磁化率的差异,采用秩和检验分析CMBs磁化率与其直径之间的相关性。结果 ICH组与腔梗组的CMBs磁化率分别为(11.78±7.18)ppm.mm3、(6.16±2.95)ppm.mm3,二者之间存在显著性差异(t=3.59,P<0.01);其直径分别为(4.03±1.16)mm、(3.05±0.9)mm,二者之间差异也存在统计学意义(t=3.39,P<0.01)。CMBs磁化率和其直径之间无明显相关(r=0.64,P<0.01)。结论磁化率更能直接反映CMBs的内在演变规律,有可能成为一项直接预测CMBs风险性的可靠指标。
Objective To investigate the difference of MR magnetic susceptibility in intracranial cerebral micro-hemorrhage (CMBs) between patients with idiopathic cerebral hemorrhage (ICH) and lacunar infarction and to evaluate the feasibility of magnetic susceptibility in predicting the risk of CMBs. Methods Totally 83 ICH and / or lacunar infarction patients with intracranial CMBs were collected, including 34 ICH patients and 49 lacunar infarcts patients. All patients underwent a 3.0 T MR fast multi-echo T2 * gradient imaging sequence. Quantitative magnetic maps were obtained by field-to-source inversion. Signal characteristics of CMBs were analyzed one by one and their diameters and magnetic susceptibility were measured. The differences of CMBs diameter and magnetic susceptibility between ICH group and lacunar infarction group were analyzed by t-test. The correlation between magnetic susceptibility and diameter of CMBs was analyzed by rank sum test. Results The magnetic susceptibility of CMBs in the ICH group and the luminal group were (11.78 ± 7.18) ppm.mm3 and (6.16 ± 2.95) ppm.mm3, respectively, with significant differences (t = 3.59, P <0.01) The diameters were (4.03 ± 1.16) mm and (3.05 ± 0.9) mm, respectively. The differences between the two groups were also statistically significant (t = 3.39, P <0.01). There was no significant correlation between magnetic susceptibility and diameter of CMBs (r = 0.64, P <0.01). Conclusion The magnetic susceptibility can directly reflect the inherent evolution of CMBs and may be a reliable indicator to directly predict the risk of CMBs.