摘要
目的:观察并评价急性缺血性脑卒中MRI弥散加权成像(DWI)作用以及其对临床进展、预后的预测。方法:对62例确诊为脑梗死的患者在不同时间行颅脑CT、常规MRI和DWI扫描后,进行影像学(包括48h内CT和DWI)的图像特征分析及ASPECT评分。患者均采用统一的治疗方案,进行病人信息、血管危险因素分析,初始和48h临床卒中症状NIHSS评分,以及改良Rankin评分。结果:病灶在发病后3天,尤其12h内在DWI上显示均质高信号,而CT、常规MRI多未能显示,在发病后8～20天内呈混杂高信号,大约在3w后高信号消失。24hDWI的ASPECT评分为预测进展性脑梗死独立因素(P<0.05)。进展性脑梗死患者改良Rankin评分较差(P<0.05)。结论:DWI诊断超早期脑梗死比CT、常规MRI有明显优势。24hDWI的ASPECT评分较高多预示进展性脑梗死的发生及较差的临床预后。
Objective： To evaluate the role, progress and prognosis of acute ischemic stroke on diffusion-weighted imaging（DWI）. Materials and Methods： Conventional CT , MRI and DWl were performed in 62 patients at different time after the onset of stroke. The signature of all imaging including ASPECTS of CT and DWI in 48h , clinical features, vascular risk factors, NIHSS of onset and 48h, modified Rankin Scale（mRS） were assessed. Results： On DWI, not CT and MRI, homogeneous high signal intensity was demonstrated in all loci of stroke in 3d and non-homogeneous high signal intensity in 8-20d after the onset respectively, but abnormal high signal intensity was lost after 3w. Only ASPECTS of DWI in 24h remained as a independent predictor of progressive stroke when a logistic regression model was applied （P〈0.05）. Modified Rankin Scale was high if progressive stroke occurred. Conclusion： In diagnosis of hyper-acute cerebral infarction, the sensitivity of DWI is higher than CT, MRI. The higher ASPECTS of DWI in 24h could predicted the occurrence of progressive stroke and poor prognosis.
出处
《脑与神经疾病杂志》
2007年第5期360-364,共5页
Journal of Brain and Nervous Diseases
