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目的 :研究脑缺血区水分子扩散运动变化的规律。探讨脑缺血区水分子扩散运动变化的可能机制。方法 :临床诊断脑缺血或脑梗死患者 43例 ,磁共振成像检查距起病 6h之内 10例 ,7～ 2 4h 12例 ,2～ 7d 7例 ,8～ 14d 8例 ,15d～ 2个月 6例 ,计算缺血区的水分子扩散速率变化。结果 :正常脑灰质区水分子扩散速率为 8.6 1×10 -4 mm2 ·s-1。早期缺血区水分子扩散迅速下降为 (4 .72× 10 -4 +1.5 1× 10 -4 )mm2 ·s-1,与对侧相应区的比值为0 .5 5± 0 .18。随发作与检查间隔延长 ,水分子扩散速率上升 ,2～ 7d为 (5 .6 8× 10 -4 ± 1.2 2× 10 -4 )mm2 ·s-1,比值为 0 .6 6± 0 .14;8～ 14d为 (9.2 2× 10 -4 ± 2 .0 7× 10 -4 )mm2 ·s-1,比值为 1.0 7± 0 .2 4。 2个月时扩散值明显升高 ,与纯水相近 ,为 (2 6 .42× 10 -4 ± 9.6 5× 10 -4 )mm2 ·s-1。扩散比值与时间呈明显相关 (r =0 .95 ,P <0 .0 0 1)。ADCv 在超早期增加后逐渐下降。结论 :超急性期脑缺血区水分子扩散速率下降 ,随时间延长扩散值逐渐上升。扩散的各向异性在超早期增加 ,随病程逐渐下降。DWI可在超急性期 (2h)发现缺血灶的存在 ,较CT及常规T1、T2 WI在脑梗死超早期诊断及演变中更有价值。超早期缺血区水分子扩散变化机制可能是超早期细?
Objective: To study the regularity of water molecule diffusion movement in ischemic area. To investigate the possible mechanism of water molecule diffusion movement in ischemic area. Methods: Forty-three patients with cerebral ischemia or cerebral infarction were diagnosed clinically. Magnetic resonance imaging was performed in 10 cases within 6 hours of onset, 12 cases of 7 to 24 hours, 7 cases of 2 to 7 days, 8 cases of 8 to 14 days, 15 days to 2 months Month 6 cases, calculate the rate of change of water molecule diffusion rate in ischemic area. Results: The diffusion rate of water molecule in normal gray matter area was 8.6 × 10 -4 mm2 · s-1. The diffusion of water molecules in the early ischemic area decreased rapidly to (4.72 × 10 -4 +1.5 1 × 10 -4) mm 2 · s -1, and the ratio to the contralateral counterpart was 0.55 ± 0.18. With the prolongation of seizure and examination interval, the rate of water molecule diffusion increased from (2 × 7d) to (2.86 × 10 -4 ± 1.2 2 × 10 -4) mm 2 · s -1 with a ratio of 0.666 ± 0.14 (9.2 2 × 10 -4 ± 2 .0 7 × 10 -4) mm2 · s-1 in 8-14 days, with a ratio of 1.07 ± 0.24. The diffusion value increased obviously at 2 months, which was similar to that of pure water (2.42 × 10 -4 ± 9.6 5 × 10 -4) mm 2 · s -1. Diffusion ratio was significantly correlated with time (r = 0.95, P <0.001). ADCv gradually decreased after the ultra-early increase. CONCLUSION: The rate of diffusion of water molecules in hyperacute cerebral ischemia area decreases, and the diffusion value gradually increases with time. Diffusion of anisotropy in the ultra early increase, with the course of the gradual decline. DWI can detect the presence of ischemic foci in hyperacute phase (2h), which is more valuable than CT and routine T1, T2WI in the ultra-early diagnosis and evolution of cerebral infarction. Ultra-early ischemic zone water molecule diffusion mechanism may be ultra-early thin?