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目的:探讨表观扩散系数(ADC)值及相对表观扩散系数(rADC)值在评价缺血性脑梗死缺血半暗带中的应用价值。方法:对42例超急性期脑梗死患者行常规CT、MRI、DSA检查,并于24h后行CT及MRI复查,根据患者出现临床症状到MRI检查时间分为超急性期(发病6h以内)、急性期(6~24h)和亚急性早期(24h~7d)。对比分析不同时期患侧梗死核心区、缺血半暗带与健侧镜像区的ADC及rADC值。结果:超急性期、急性期及亚急性期梗死核心区ADC值及rADC值均低于健侧镜像区,缺血半暗带ADC值及rADC值仅轻度下降,平均降幅为20%。梗死核心区与缺血半暗带ADC值及rADC值随着发病时间延长,上升趋势不同。缺血半暗带ADC值及rADC值均高于梗死核心区,差异有统计学意义(P<0.01)。结论:ADC值及rADC值对判定缺血半暗带具有较高的临床应用价值,有望成为一种简便易行的确定缺血半暗带的检查方法,为指导患者进行临床治疗提供重要的影像学依据。
Objective: To investigate the value of apparent diffusion coefficient (ADC) and relative apparent diffusion coefficient (rADC) in the evaluation of ischemic penumbra in ischemic cerebral infarction. Methods: Twenty-four patients with hyperacute cerebral infarction underwent routine CT, MRI and DSA examinations. CT and MRI were performed 24 hours later. According to clinical symptoms and MRI examination, the patients were divided into hyperacute phase (within 6 hours after onset) Acute phase (6 ~ 24h) and subacute early (24h ~ 7d). The ADC and rADC values of infarction core area, ischemic penumbra and contralateral mirrored area in different periods were compared and analyzed. Results: The values of ADC and rADC in infarction core area in hyperacute, acute and subacute phases were lower than those in contralateral mirrored area. The values of ADC and rADC in ischemic penumbra decreased only slightly with an average decrease of 20%. The infarct core area and ischemic penumbra with ADC value and rADC value increased with the onset time, the rising trend is different. The ADC value and rADC value in ischemic penumbra were higher than those in infarct core area, with significant difference (P <0.01). Conclusion: ADC value and rADC value have high clinical value in determining ischemic penumbra, which is expected to become a simple and easy method to determine ischemic penumbra and provide important images for guiding clinical treatment of patients Learn from.