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目的:探讨磁敏感成像(SWI)在诊断腔隙性脑梗死中的应用价值。方法:选择临床拟诊的腔隙性脑梗死120例,随机分为观察组与对照组各60例。对照组采用CT和MRI常规序列扫描,并接受氯吡格雷+阿司匹林双联抗血小板治疗;观察组在对照组基础上加做SWI扫描,并根据SWI结果给予个性化治疗;对比两组影像学检查结果和临床疗效。结果:(1)两组采用MRI检出的脑梗死病灶数均显著高于CT检出数;而对于微出血病灶,CT和常规MRI检查均无法清晰显示,但观察组SWI检查发现17例共86处微出血灶。(2)两组治疗前及治疗24h后中国临床神经功能缺损评分(CSS)比较,差异不显著(P>0.05);观察组治疗21天后和3个月后CSS评分均显著优于对照组(P<0.05)。(3)观察组治疗期间出现出血转化2例(3.3%)显著低于对照组的8例(13.3%)(P<0.05)。结论:SWI能够为腔隙性脑梗死的诊断提供更多影像学信息,对指导临床个体化治疗有一定帮助。
Objective: To explore the value of magnetic susceptibility imaging (SWI) in the diagnosis of lacunar infarction. Methods: One hundred and twenty cases of lacunar infarction were selected from clinical trial and randomly divided into observation group and control group with 60 cases each. The control group was scanned by CT and MRI, and received dual antiplatelet therapy with clopidogrel and aspirin. The observation group was given SWI scan based on the control group and was treated according to the SWI results. Comparing the two groups, Results and clinical efficacy. Results: (1) The numbers of cerebral infarction detected by MRI in both groups were significantly higher than those detected by CT, while the results of CT and routine MRI were not clearly shown in the micro-hemorrhagic lesions, but 17 cases 86 micro-hemorrhage. (2) There was no significant difference in clinical neurological deficit scores (CSS) between the two groups before treatment and after treatment for 24 h (P> 0.05). The CSS scores of the observation group after 21 and 3 months were significantly better than those of the control group P <0.05). (3) There were 2 cases (3.3%) of bleeding in observation group during treatment, which was significantly lower than that in control group (13.3%) (P <0.05). Conclusion: SWI can provide more imaging information for the diagnosis of lacunar infarction, and it will be helpful to guide clinical individualized treatment.