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目的探讨各期脑出血MRI诊断及信号演变特征,以提高对本病的诊断水平。方法分析临床确诊的65例脑出血患者MRI影像资料。结果 65例中,超急性早期(6h内)3例,T_1WI为等信号,T_2WI为等信号,T_2Flair为稍低信号,DWI为低信号,周围无水肿;超急性晚期(6~24h)7例,T_1WI为稍低信号,T_2WI为稍高信号,T_2Flair为稍低信号,DWI为低信号,周围轻度水肿;急性期(1~3d)8例,T_1WI为等信号,T_2WI为低信号,T_2Flair为极低信号,DWI为极低信号,周围中度水肿;亚急性早期(4~7d)7例,T_1WI为外高中低信号,T_2WI为低信号,T_2Flair为低信号,DWI为低信号,周围重度水肿;亚急性中期(8~15d)11例,T_1WI为高信号,T_2WI为外高中低信号,T_2Flair为外高中低信号,DWI为外高中低信号,周围中度水肿;亚急性晚期(16~30d)7例,T_1WI为高信号,T_2WI为高信号,T_2Flair为高信号,DWI为高信号,周围轻微水肿;慢性期(1~2个月)7例,T_1WI为高信号,T_2WI为高信号,周围有黑环,T_2Flair为高信号,周围有黑环,DWI为高信号,周围有黑环,病变周围无水肿;残腔期(3个月以上)15例,T_1WI为低信号,T_2WI为高信号,周围有黑环,T_2Flair为低信号,DWI为低信号,病变周围无水肿。结论不同期别脑出血的MRI表现具有特征性,超急性期、急性期出血在T_2Flair、DWI均表现为低信号,而亚急性期出血在T_1WI表现为高信号,慢性期、残腔期T_2WI病变周围有低信号环为特点。
Objective To investigate the characteristics of MRI diagnosis and signal evolvement of cerebral hemorrhage in different stages to improve the diagnosis of this disease. Methods MRI data of 65 patients with cerebral hemorrhage were analyzed clinically. Results Among the 65 cases, 3 cases were hyperacutely early (within 6h), T_1WI was equal signal, T_2WI was equal signal, T_2Flair was slightly lower signal, DWI was low signal and there was no surrounding edema. , T_1WI is a slightly lower signal, T_2WI is a slightly higher signal, T_2Flair is a slightly lower signal, DWI is a low signal, with mild peripheral edema; acute phase (1 ~ 3d) 8 cases, T_1WI is equal signal, T_2WI is low signal, T_2Flair DWI is a very low signal, with moderate peripheral edema. In the subacute early stage (4 ~ 7 days), 7 cases showed T_1WI as low and high signal, T_2WI as low signal, T_2Flair as low signal, DWI as low signal, Severe edema; subacute mid-term (8 ~ 15d) in 11 cases, T_1WI is high signal, T_2WI is outside the high and low signal, T_2Flair is outside the high and low signal, DWI is outside the high and low signal, ~ 30 days), 7 cases of T_1WI were high signal, T_2WI was high signal, T_2Flair was high signal and DWI was high signal with slight edema around. In chronic phase (1 ~ 2 months), 7 cases showed high T_1WI signal and T_2WI was high Signal, surrounded by a black ring, T_2Flair is a high signal, surrounded by a black ring, DWI is a high signal around the black ring, no edema around the lesion; residual cavity (15 months) in 15 cases, T_1WI low signal, T_2WI for Signal, there is a black ring around, T_2Flair low signal, low signal DWI, no edema around the lesion. Conclusions The MRI findings of different stages of cerebral hemorrhage are characteristic. The hyperacute and acute hemorrhage showed low signal in T_2Flair and DWI, while the subacute hemorrhage showed high signal in T_1WI. In chronic phase, residual T_2WI lesion Around the low signal ring is characterized.