摘要：目的：探讨综合应用磁共振T2WI、FLAIR、DWI及rADC值对腔隙性脑梗塞病灶的发现和发病时间的定性诊断能力。方法: 搜集83例经临床诊断并有MRI证实的腔隙性脑梗塞病例。所有病例均有不同程度腔隙性脑梗塞综合征表现。根据发病时间分为三组：急性期腔隙性脑梗塞组，25例，发病时间<3d；亚急性期腔隙性脑梗塞组，41例，发病时间3d～1月；慢性期腔隙性脑梗塞组，17例，发病时间>1 月。所有病例均行颅脑轴位DWI、ADC图、FLAIR及T1WI、T2WI检查，资料录入SPSS 10.0软件做相关性分析及独立样本t检验。结果：对于急性期腔隙性脑梗塞病灶的诊断，DWI和rADC明显优于其他序列；对于亚急性期腔隙性脑梗塞病灶的诊断，FLAIR明显优于其他序列；对于慢性期腔隙性脑梗塞病灶的诊断，FLAIR具有特征性表现，结合T2WI可以确诊；腔隙性脑梗塞病灶rADC值与发病时间呈正相关(r＝0.871)；各不同时间段腔隙性脑梗塞病灶的rADC值有极显著性统计学差异(P<0.01)。结论：不同时期腔梗灶在DWI、T2WI和FLAIR上各有特点，综合该三个序列能更好地发现病灶并评估病灶的性质；结合rADC值，更精确地估计病灶的发病时间。

    关键词：磁共振；腔隙性脑梗塞； 弥散加权成像；液体衰减反转恢复序列

    The Time Course Study of Lacunar Infarct: Using T2WI、FLAIR、DWI and rADC

    CHEN Zhen-qiang, GUO Yue-lin,LIU Guo-rui,et al

    (The Second Affiliated Hospital of Shantou University Medical College, Guangdong Shantou 515041, China)

    Abstract： Objective: To study the value of MRI T2WI, FLAIR, DWI and rADC in the time course diagnosis of lacunar infarct. Method :Patients (n=83) with different time course lacunar infarct were including in this study; all patients were confirmed by clinic and MRI. According to the time course of infarct, the patients were divided into 3 groups: acute group (n=25), the time course < 3 days; subacute group (n=41), the time course was from 3 days to 1 month; chronic group (n=17), the time course > 1 month. The basic sequences were including DWI, ADC maps, FLAIR, T1WI and T2WI. Result: To acute lacunar infarct, DWI and rADC were the best. To subcuate lacunar infarct, FLAIR was the best. To chronic lacunar infarct, FLAIR and T2WI were the best. Conclusion: Combined T2WI , FLAIR , DWI with rADC, the time course diagnosis of lacunar infarct could be well done. ......