摘要
目的应用弥散加权成像(DWI)、灌注加权成像(PWI)界定超早期脑梗死缺血半暗带,以提出量化评定标准。方法 13例发病时间在2￣6h以内的超早期脑梗死患者行MRI检查,包括DWI和PWI,并在2￣28d内复查T2WI确定最终梗死范围。对梗死中心区、缺血半暗带及对侧镜像区,测量其扩张变化和血流灌注。结果①梗死中心区与缺血半暗带表观弥散系数(ADC)平均值分别为7.01×10-4mm2/s及9.36×10-4mm2/s,rADC平均值分别为0.63及0.87。梗死中心区ADC及rADC均明显降低,缺血性半暗带ADC及rADC轻度下降,两者之间有显著性差异。②PWI显示11例超早期脑梗死存在灌注缺损区或灌注减低区,2例腔隙性脑梗死未见明显异常。③对于PWI>DWI者,ADC值轻度降低(<22%)的区域可能为缺血性半暗带;而ADC值明显降低(25%～53%)的区域(16%～34%)可能为不可逆损伤区。结论 DWI与PWI的联合应用可发现超早期脑梗死,并预测缺血半暗带。
【Objective】 To explore the ischemic penumbra of the hyperacute infarct by diffusion weighted imaging （DWI） and perfusion weighted imaging （PWI）,trying to raise the quantitative evaluation standards.【Methods】MRI was performed in 13 patients with clinically diagnosed hyperacute infarct from 2h to 6h after the onset of symptoms,including DWI and PWI.All the patients were followed up by T2WI image to determine the final infarct area within 2 to 28 days.Diffusion and perfusion changes were measured in the infarct area,ischemic penumbra and control area.【Results】 ①The average value of apparent diffusion coefficient （ADC） in the infarct center was 7.01×10-4 mm2/s and that of rADC was 0.63,as for the ischemic penumbra,the average value of ADC was 9.36 ×10-4 mm2/s,and that of rADC was 0.87.The difference was significant.② PWI demonstrated the regional cerebral blood reduction or absence in 11 patients.However,in two patients with lacunar cerebral infarct,PWI was normal.③If PWIDWI,the area with slightly decreased ADC value （22%） might be the ischemic penumbra,while the area with obviously decreased ADC（25%～53%） was irreversible infarct area.【Conclusion】 DWI combined with PWI can diagnose the hyperacute infarct and evaluate the change of ischemic penumbra.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第15期2309-2312,共4页
China Journal of Modern Medicine
关键词
脑梗死
缺血性半暗带
弥散加权成像
灌注加权成像
cerebral infarct
ischemic penumbra
diffusion weighted imaging
perfusion weighted imaging
