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目的磁共振弥散张量成像在脑梗死不同时期的诊断价值。方法回顾性分析2012年7月至2015年2月住院治疗的脑梗死患者48例,所有患者均于症状出现起病时间≤6h,15d、及3个月和6个月时完成7次MRI检查,并根据Fugl-Meyer运动量表进行神经功能缺损程度评价并记录评分。观察磁共振弥散张量成像的诊断价值及与神经功能缺损程度的相关性。结果 48例脑梗死患者发病超急性期及急性期诊断病变的敏感度DWI明显高于MR平扫二者差异有统计学意义(P<0.05);随着病程的延长,脑干的梗死灶在DWI图上的信号逐渐降低,到发病后第3个月时逐渐演变为等或者低信号,而ADC图逐渐升高;相关分析结果显示,发病6d内的脑干梗死灶r ADC值与同期(r=0.046,P=0.894),以及发病后3个月(r=0.046,P=0.893)和6个月(r=0.122,P=0.722)时的FMMS评分均无相关关系;超急性期b=800时阳性率高,图像清晰,信号强度高。结论DWI像比常规MR像对诊断急性脑梗死敏感,并能鉴别急性与非急性脑梗死。
Objective To evaluate the diagnostic value of MR diffusion tensor imaging in different stages of cerebral infarction. Methods Forty-eight patients with cerebral infarction hospitalized from July 2012 to February 2015 were retrospectively analyzed. All of the patients underwent MRI examination 7 days after symptom onset onset ≤6h, 15d, 3 months and 6 months , And according to Fugl-Meyer motor scale assessment of neurological deficits and record scores. To observe the diagnostic value of MR diffusion tensor imaging and its correlation with the degree of neurological deficit. Results The sensitivity of DWI in 48 patients with acute cerebral infarction and acute phase was significantly higher than that of MR (P <0.05). With the prolongation of disease duration, The signal on DWI decreased gradually and gradually changed to equal or low signal at the third month after onset, while the ADC increased gradually. The correlation analysis showed that the r ADC value of infarction in brain stem within 6d (r = 0.046, P = 0.894), FMMS score at 3 months after onset (r = 0.046, P = 0.893) and 6 months (r = 0.122, P = 0.722) = 800 when the positive rate, clear images, high signal strength. Conclusion DWI is more sensitive than conventional MR imaging in the diagnosis of acute cerebral infarction, and can distinguish between acute and non-acute cerebral infarction.