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1、1ESWAN序列对脑梗死脑内微出血的诊断价值勒都晓兰,吕发金,陈莉,姚开情,李剑秋(400016重庆,重庆医科大学附属第一医院放射科)[摘要]目的探讨增强梯度回波T*加权血管成像(ESWAN)序列在诊断脑梗死伴发脑微出血(cerebral2microbleeds,CMBs)中不同影像学表现的价值。方法收集2011年3月至10月于我院检查诊断脑梗死的55例患者的影像学资料,记录ESWAN图像上CMBs发生部位、数目、表现。结果55例患者中,ESWAN共检出CMBs52.73%(29/55),MRI2常规序列检出CMBs29.09%(16/55)(χ=6.36,P<0.05),同
2、时行头颅CT平扫的34例患者中8.82%(3/34)发现梗死2灶内少量出血(χ=29.79,P<0.01)。ESWAN图像上,51.72%(15/29)的患者CMBs的表现为小圆形信号缺失,仅位于梗死灶外,37.93%(11/29)表现为小片状、条状信号缺失,仅位于梗死灶内,10.34%(3/29)梗死灶内外均有CMBs。此29例患者中,37.93%(11/29)为腔隙性脑梗死,其中81.82%(9/11)表现为梗死灶外CMBs;48.28%(14/29)为大面积梗死,其中71.43%(10/14)表现为梗死灶内CMBs。脑梗死不同分期间CMBs的发生差异有统计学意义(P<0
3、.05)。脑梗死存在脑软化灶时更易发生CMBs(P<0.05)。结论CMBs的出现与血管的损伤程度有关,ESWAN对脑梗死伴CMBs的诊断有重要价值。[关键词]脑微出血;增强梯度回波T*2加权血管成像;磁共振成像[中图法分类号][文献标识码]ThediagnosisvalueofcerebralinfarctionwithcerebralmicrobleedsbyESWANsequenceLeduXiaolan,LvFajin,ChenLi,YaoKaiqing,LiJianqiu(DepartmentofRadiology,theFirstAffiliatedHospita
4、lofChongqingMedicalUniversity,Chongqing,400016,China)[Abstract]ObjectiveToinvestigatethevalueofenhancedgradientechoT*2weightedangiography(ESWAN)performancesincerebralinfarctionwithcerebralmicrobleeds(CMBs).MethodsImaginesof55patientswhowerediagnosedwithcerebralinfarctionfromMarchtoOctoberin
5、2011inourhospitalwerecollected.Thesites,numbers,characteristicsofCMBsonESWANwererecorded.ResultsCMBsweredetectedin52.73%(29/55)casesonESWAN,whichweredetectedin29.09%(16/55)casesonconventionalMRsequences(χ2=6.36,P<0.05),andin8.82%(3/34)ofthe34caseswhotookCTscan(χ2=29.79,P<0.01).Amongthe29cas
6、es,51.72%(15/29)CMBsrepresentedassmallroundsignalloss,whichlocatedonlyoutsideoftheinfarctionlesions,and37.93%(11/29)patientsrepresentedassmallsheet,stripsignallost,onlyintheinfarctionlesions,andCMBsin10.34%(3/29)patientswerebothinandoutside.37.93%(11/29)caseswerelacunarinfarctioninthese29ca
7、ses,81.82%(9/11)ofwhichwereoutsideCMBs.48.28%(14/29)caseswerelargeinfarction,71.43%(10/14)ofwhichwereinsideCMBs.Differencebetweencerebralinfarctionstageswasstatisticallysignificant(P<0.05).CMBsincerebralinfarctionwithencephalomalaciaoccurredmoreeasily(P<