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目的 研究磁共振弥散加权成像 (DWI)诊断急性皮层下脑梗塞的准确性以及对急性与非急性皮层下脑梗塞的鉴别诊断价值。材料与方法 对 32例临床诊断为急性皮层下脑梗塞的患者和 2 0例对照者在不同时间内进行常规MRI检查和弥散加权MRI检查 ,并用盲法进行对照观察。对所有病例的病变部位均按神经解剖进行准确定位并与患者的症状、体征相联系。结果 DWI诊断急性皮层下脑梗塞的敏感性、特异性及准确性分别为 97%、95 %和 96 %。 32例中有 3例常规MRI检查未发现急性梗塞灶。另 2 0例常规MRI检查均显示为多发梗塞 ,而DWI只显示单个急性病灶 ,且患者的症状、体征与DWI上显示的病灶相符。结论 DWI对诊断急性皮层下脑梗塞有很高的准确性 ,能发现常规T2 WI不能发现的早期脑梗塞 ,并能鉴别急性与非急性梗塞。
Objective To study the accuracy of magnetic resonance diffusion-weighted imaging (DWI) in the diagnosis of acute subcortical cerebral infarction and the differential diagnosis of acute and non-acute subcortical cerebral infarction. MATERIALS AND METHODS Twenty-two patients with clinically diagnosed acute subcortical cerebral infarction and 20 controls were examined by conventional MRI and diffusion-weighted MRI at different times, and were observed by blinded control. The lesions of all cases were accurately located according to the nerve anatomy and associated with the patient’s symptoms and signs. Results The sensitivity, specificity and accuracy of DWI in the diagnosis of acute subcortical cerebral infarction were 97%, 95% and 96% respectively. Three of the 32 patients had no acute infarction detected by conventional MRI. The other 20 routine MRI examination showed multiple infarcts, while DWI showed only a single acute lesion, and the symptoms and signs of the patients were consistent with the lesions showed on DWI. Conclusion DWI has high accuracy in diagnosing acute subcortical cerebral infarction. It can detect early cerebral infarction which can not be found in conventional T2 WI and can distinguish between acute and non-acute infarction.