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目的探讨扩散加权磁共振成像(MRI-DWI)在急性脑梗死患者中的应用价值。方法选取2014年12月—2015年12月中国医科大学附属第一医院收治的急性脑梗死患者25例。采用1.5T MRI扫描仪对患者的头部进行扫描,观察病灶的MRI扫描序列和弥散加权成像(DWI)图像,根据DWI图像选取病灶区域,计算曲线下面积(ADC)。结果 25例患者中,超急性脑梗死4例(16.0%),急性脑梗死21例(84.0%);多发性脑梗死14例(56.0%),半卵圆中心脑梗死1例(4.0%),基底核区域脑梗死7例(28.0%),脑干脑梗死3例(12.0%)。25例患者DWI检查的病灶区域均显示高信号,灵敏度为100.0%。21例急性脑梗死患者的ADC图显示为低信号,T1W1显示低信号,T2W1显示稍高信号,FLAIR显示高信号;4例超急性脑梗死患者的ADC图显示为中等信号,T1W1显示高信号,T2W1显示高信号,FLAIR显示高信号。病灶区域的ADC低于正常脑组织(P<0.05)。结论 MRI-DWI可以明确急性脑梗死患者的病变部位,确定病灶大小,区分新旧病灶,值得在临床上推广使用。
Objective To investigate the value of diffusion-weighted magnetic resonance imaging (MRI-DWI) in patients with acute cerebral infarction. Methods Twenty-five patients with acute cerebral infarction who were admitted to the First Affiliated Hospital of China Medical University from December 2014 to December 2015 were selected. A 1.5T MRI scanner was used to scan the patient’s head. The lesion’s MRI scan sequence and DWI images were observed. The lesion area was calculated according to DWI images and the area under the curve (ADC) was calculated. Results Among the 25 patients, there were 4 cases (16.0%) of acute cerebral infarction, 21 cases (84.0%) of acute cerebral infarction, 14 cases of multiple cerebral infarction (56.0%) and 1 case of semilunar infarction , Basal ganglia infarction in 7 cases (28.0%), brainstem infarction in 3 cases (12.0%). All 25 patients had high signal intensity in the lesion area of DWI, with a sensitivity of 100.0%. The ADC maps of 21 patients with acute cerebral infarction showed low signal, T1W1 showed low signal, T2W1 showed slightly high signal and FLAIR showed high signal. The ADCs of 4 patients with hyperacute cerebral infarction showed moderate signal, T1W1 showed high signal, T2W1 shows a high signal and FLAIR shows a high signal. The lesion area had lower ADC than normal brain tissue (P <0.05). Conclusion MRI-DWI can identify the lesion in patients with acute cerebral infarction, determine the size of the lesion, distinguish between new and old lesions, it is worth to promote the use of the clinical.