王宝军 李美琳 王建利 王芬 李美琳 王芬 100083 北京医科大学第三临床学院神经内科；王宝军 现在包头市中心医院神经内科；王建利 放射科 中华神经科杂志 1999 0 32 5


    关键词：磁共振成像；脑缺血；脑血管意外；诊断 期刊 zhsjkzz 0 论著 fur -->


    

【摘要 】 目的 评价弥散成像(DWI)、血流灌注成像(PWI)磁共振对急性缺血性脑血管病的诊断价值。方法 用DWI、PWI诊断急性脑缺血,并与常规MRI结果比较。结果 经MRI检查证实的急性缺血性脑血管病患者共22例。其中发病后90分钟至6小时检查者11例，其CT及常规MRI未见异常，3例短暂性脑缺血发作(TIA)患者的DWI、PWI正常；其余8例脑梗死患者经DWI、PWI检查，均发现相对应的病灶，且6例灌注减低体积(PWIv)>弥散异常体积(DWIv)，2例PWIv=DWIv。起病在6～12小时5例，4例行PWI检查，3例PWIv>DWIv，1例PWIv=DWIv。起病在12～48小时6例，2例行PWI检查，PWIv=DWIv。 8例陈旧病灶在DWI上表现为低信号，所有新病灶在DWI上均为高信号。结论 DWI、PWI可超早期诊断脑梗死，并可帮助了解缺血半暗带。T₂ 加权像和DWI结合可以鉴别新旧梗死灶。

The value of diffusion-weighted and perfusion-weighted MRI in the diagnosis of acute ischemic cerebrovascular disease

WANG Baojun, LI Meilin, WANG Jianli, et al.

    Department of Neurology, the Third Hospital, Beijing Medical University, Beijing 100083

【Abstract 】 Objective To evaluate the role of MR diffusion-weighted imaging (DWI) and perfusion-weighted imaging(PWI) in the diagnosis of acute ischemic cerebrovascular disease. Method DWI and PWI were performed on 22 patients with acute cerebral ischemia, and were compared with routine MRI. Results There were 22 patients with acute ischemic cerebrovascular disease diagnosed by MRI. Eleven patients were in the hyperacute stage so that the ischemic lesion could not be detected with CT and routine MRI. Among those patients,3 of them with transient ischemic attacks had DWI and PWI, whereas the other 8 patients with cerebral infarction were identified to be hyperacute ischemic lesions by DWI and PWI and the 6 patients′ abnormal perfusion regions were larger than the hyperintense areas shown by DWI. Two patients′ abnormal perfusion regions were as large as the hyperintense areas shown by DWI. Five patients′ attacks occurred in 6～12 hours after the onset only four patients had PWI examinations performed, three patients′ abnormal perfusion regions were larger than the hyperintense areas shown by DWI. One patient′s abnormal perfusion region was as large as the hyperintense areas shown by DWI. Six patients had their onset attacks in 12～48 hours. Only two of them had PWI examinations performed.The abnormal perfusion region was as large as the hyperintense areas shown by DWI. Eight chronic lesions were identified as hyperintense regions in DWI. All early ischemic lesions were identified as hyperintense regions in DWI. Conclusion DWI and PWI can be used to diagnose hyperacute cerebral infarction,and to demonstrate ischemic penumbrae and even to identify the lesion′s stages.

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