摘要
目的探讨多模态磁共振成像在急性缺血性脑卒中(AIS)的诊断价值及溶栓、取栓中的风险评估.方法回顾性分析经临床证实的47例AIS患者的临床及影像资料,磁共振成像采用常规序列,部分使用三维动脉自旋标记成像(3D-ASL)、扩散加权成像(DWI)、磁敏感加权成像(SWAN)等多模态成像,分析其诊断价值及治疗风险评估.结果所有患者磁共振影像显示不同大小范围脑梗死;3D-ASL显示均有低灌注区,有31例患者存在缺血半暗带,复查后有6例出现高灌注,后发生出血转化(HT);有2例患者不同灌注延迟时间均为低灌注区,但在PLD 1.5s时,病变周围扭曲血管影(ATA),提示侧支循环代偿良好,调整治疗方案,未发生HT等并发症.有4例患者经过SWAN扫描发现点状、片状低信号,后期复查已证实出血转化.结论多模态磁共振成像在AIS的诊断及溶栓、取栓治疗中具有重要应用价值.DWI及ADC可精准诊断AIS,SWAN及3D-ASL预估出血转化,对调整诊疗方案有指导意义.
Objective To explore the value of multi modal MRI in the diagnosis of acute ischemic stroke(AIS)and patient risk asessent in thrombolysis and thrombectomy.Methods A rtrospective analysis was conducted.47 patents with AIS who met the condions and were cinically confirmed in our hospial.Using conventional sequence,and prially targeted with muli modal imaging,such as 3D-ASL,DWI and SWAN were analyzed and dicussed.Results The images of the slcted cases showed cerebral infarction in diferent size ranges.3D-ASL showed that all cases had low-perfusion areas,and 31 patients had amn ischemic penumbra.Post-review for 3D-ASL in six cases,high perfision ocurred,and the hemorrthagic transformation(HT)fllowing occurred.In the two patiens,diferent prfusion delays were low perfusion areas.But at PLD=1.5 s,it showed twisted vascular shadow around the lesion(ATA).It suggested that the collateral circulation is well compensated.After adjusting the clinical treatment plans,no complcations such as HT occurred.Signs of punctate and patchy low signal after SWAN scan were found in 4 patient,and bleeding transformation was confirmed by the later review.Conclusion Multi-modal MR has important application value in the diagnosis,thrombolysis and thrombectomy therapy of AIS.DWI and ADC can accurately diagnose AIS.SWAN and 3D-ASL can predict hemorrhagic transformation,and they have guiding sgnifiance for the adjusment of diagnosis and treatmnent plan.
出处
《浙江临床医学》
2022年第9期1381-1382,1387,共3页
Zhejiang Clinical Medical Journal
关键词
急性缺血性脑卒中
磁共振成像
三维动脉自旋标记成像
扩散加权成像
磁敏感加权成像
出血转化
Acute ischemic stroke
Magnetic resonance imaging
3D-Arterial spin labeling technique
Diffusion-weighted imaging
Susceptibility weighted imaging
Hemorrhagic transformation
