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目的:探讨磁共振弥散加权成像(magneticresonancediffusionimaging,DW-MRI)评估急性脑梗死治疗后的缺血面积与临床疗效评价是否具有很好的一致性,能否反映治疗过程中病变脑组织的康复状态。方法:中国医科大学附属第一医院急诊科和神经内科住院治疗、符合《实用神经病学(第3版)》急性脑梗死诊断标准、排除脑出血、脑肿瘤、脑栓塞及短暂性脑缺血发作等疾病、发病超过6h的急性前循环脑梗死患者21例,分别于治疗前及治疗后6,12,24h、1周、1个月行DW-MRI扫描,并计算各个时间点的缺血最大层面的缺血面积及其扩大或缩小程度。同时于治疗前及治疗后1周、1个月进行神经功能缺损评定,评估疗效。结果:治疗后24h内缺血面积缩小者1例、无变化者5例、扩大者15例,治疗后1周、1个月缺血面积缩小者分别为5例、10例,无变化者分别为10例、8例,与相应临床疗效评价具有很好的一致性。结论:急性脑梗死经综合治疗后缺血面积的动态变化与临床疗效判定结果密切相关,DW-MRI可以作为其疗效判定的很好的影像学方法。
Objective: To investigate whether magnetic resonance diffusion-weighted imaging (DW-MRI) can evaluate whether ischemic area and clinical efficacy of acute cerebral infarction after acute cerebral infarction have a good consistency and whether it can reflect the state of brain tissue recovery during the treatment. Methods: Inpatient department of emergency department and neurology department of the First Affiliated Hospital of China Medical University met the diagnostic criteria of “Practical Neurology (3rd edition)” acute cerebral infarction and excluded cerebral hemorrhage, brain tumor, cerebral embolism and transient ischemic attack And other diseases. The incidence of acute cerebral infarction in patients with acute cerebral infarction over 6h 21 patients, respectively, before treatment and after treatment 6,12,24 h, 1 week, 1 month underwent DW-MRI scan, and calculate the maximum ischemia at each time point The level of ischemic area and its extent of expansion or contraction. At the same time before treatment and after treatment for 1 week, 1 month for neurological deficit assessment to assess the efficacy. Results: Within 24 hours after treatment, the ischemic area was reduced in 1 case, no change in 5 cases, enlarged in 15 cases. After 1 week and 1 month of treatment, the ischemic area was reduced in 5 cases and 10 cases, respectively 10 cases, 8 cases, with the corresponding clinical evaluation has good consistency. Conclusion: The dynamic change of ischemic area after acute cerebral infarction is closely related to the outcome of clinical curative effect. DW-MRI can be used as a good imaging method to determine the curative effect.