摘要
目的分析磁共振弥散加权成像技术(DWI)诊断脑梗死的临床价值。方法抽取2018年2月至2021年5月河南省直第三人民医院收治的疑似脑梗死患者189例,均行DWI、常规磁共振成像(MRI)扫描,以数字减影血管造影(DSA)检查结果为"金标准",比较DWI、常规MRI诊断脑梗死的诊断结果、诊断效能和不同序列检出情况,并比较不同部位、不同时期的表观弥散系数(ADC)值。结果189例疑似脑梗死患者经DSA检查结果证实脑梗死162例,其他高血压性脑病27例;DWI诊断出脑梗死161例,非脑梗死28例;常规MRI诊断出脑梗死156例,非脑梗死33例。DWI诊断的灵敏度为98.77%(160/162),准确度为98.41%(186/189),高于常规MRI诊断的93.21%(151/162)、91.53%(173/189),P<0.05;DWI检查的漏诊率(1.23%,2/162)低于常规超声检查(6.79%,11/162),P<0.05。DWI诊断方法T1加权像、T2加权像、液体衰减反转恢复序列检出率分别为93.21%(151/162)、89.51%(145/162)、95.06%(154/162),高于常规MRI的62.96%(102/162)、56.79%(92/162)、67.28%(109/162),P<0.05。不同b值下患侧ADC值均低于健侧(P均<0.05),不同b值下超急性期ADC参数均低于急性期、亚急性期和慢性期(P均<0.05)。结论DWI诊断脑梗死可提高诊断灵敏度、准确度,降低漏诊率,不同序列检出率高,且患侧和疾病发病早期ADC值显著降低,DWI技术能为临床诊断脑梗死提供更多信息支持。
Objective To analyze the clinical value of magnetic resonance diffusion weighted imaging(DWI)in the diagnosis of cerebral infarction.Methods A total of 189 patients with suspected cerebral infarction treated in the Third Provincial People’s Hospital of Henan Province from February 2018 to May 2021 were selected,all of them underwent DWI and conventional magnetic resonance imaging(MRI).Taking digital subtraction angiography(DSA)examination results as the gold standard,the diagnosis results,diagnostic efficiency and detection of different sequences of DWI and conventional MRI in the diagnosis of cerebral infarction were compared,and apparent dispersion coefficient(ADC)values in different parts and different periods were compared.Results Among the 189 patients with suspected cerebral infarction,DSA confirmed 162 cases cerebral infarction and 27 cases other hypertensive encephalopathy;DWI indentified cerebral infarction in 161 cases and non-cerebral infarction in 28 cases;conventional MRI indentified cerebral infarction in 156 cases and non-cerebral infarction in 33 cases.The diagnostic sensitivity and accuracy of DWI were 98.77%(160/162)and 98.41%(186/189),respectively,which were higher than 93.21%(151/16)and 91.53%(173/189)of conventional MRI(P<0.05).The rate of missed diagnosis of DWI was 1.23%(2/162),lower than the 6.79%(11/162)of conventional ultrasound(P<0.05).The detection rates of DWI diagnostic methods T1 weighted imaging,T2 weighted imaging and fluid attenuated inversion recovery sequence were 93.21%(151/162),89.51%(145/162)and 95.06%(154/162),respectively,which were higher than 62.96%(102/162),56.79%(92/162),67.28%(109/162)of conventional MRI(P<0.05).ADC values of the affected side were lower than those of the healthy side under different b values(all P<0.05).ADC parameters in hyperacute stage were lower than those in acute stage,subacute stage and chronic stage under different b values(all P<0.05).Conclusions DWI diagnosis of cerebral infarction can improve the diagnostic sensitivity and accuracy,reduce the missed diagnosis rate,the detection rate of different sequences is high,and the ADC value of the affected side and the early stage of the disease is significantly reduced.DWI technology can provide more information support for clinical diagnosis of cerebral infarction.
作者
郁永虎
孙耀煜
刘磊
Yu Yonghu;Sun Yaoyu;Liu Lei(Department of Imaging,the Third Provincial People’s Hospital of Henan Province,Zhengzhou 450000,China)
出处
《中国实用医刊》
2022年第16期86-89,共4页
Chinese Journal of Practical Medicine
关键词
脑梗死
磁共振弥散加权成像
表观弥散系数
诊断效能
Cerebral infarction
Magnetic resonance diffusion weighted imaging
Apparent dispersion coefficient
Diagnostic efficiency
