發(fā)布時(shí)間：2018-02-24 00:17

  本文關(guān)鍵詞： 磁敏感加權(quán)成像 腦腫瘤出血 非腫瘤性腦出血 鑒別診斷　出處：《山西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討腦腫瘤出血和非腫瘤性腦出血的磁敏感加權(quán)成像(susceptibility weighted imaging, SWI)表現(xiàn)特點(diǎn)；比較磁共振增強(qiáng)掃描(contrast-enhanced magnetic resonance imaging, CE·MR)、SWI及二者聯(lián)合應(yīng)用對(duì)腦腫瘤出血和腦內(nèi)非腫瘤性出血的鑒別診斷價(jià)值。 方法收集山西醫(yī)科大學(xué)第一臨床醫(yī)院2011年12月至2013年12月間經(jīng)手術(shù)病理或臨床隨訪證實(shí)的腦腫瘤出血病例26例和非腫瘤性腦出血病例26例,分別行MR平掃、CE-MR、SWI檢查,其中腦腫瘤出血組包括星形細(xì)胞瘤12例、轉(zhuǎn)移瘤11例、少突膠質(zhì)細(xì)胞瘤3例；非腫瘤性腦出血組包括高血壓性腦出血10例,單純性腦出血3例,血管畸形出血13例(海綿狀血管瘤出血5例,動(dòng)靜脈畸形出血3例,靜脈畸形出血2例,混合性血管畸形出血3例)。對(duì)CE-MR、SWI及CE-MR與SWI聯(lián)合應(yīng)用對(duì)腦出血病因診斷的正確率進(jìn)行比較。 結(jié)果(1)腦出血形態(tài)分為灶樣出血型和結(jié)節(jié)腫塊型,腦腫瘤出血病例組中,21例病灶未出血部位可見不同程度強(qiáng)化；5例出血基本覆蓋腫瘤,增強(qiáng)掃描邊緣可見不規(guī)則強(qiáng)化。非腫瘤性腦出血病例組中,10例高血壓腦出血和3例單純性腦出血病例可見輕度強(qiáng)化,強(qiáng)化形態(tài)與血腫形態(tài)相似。(2)腦腫瘤出血病例血腫信號(hào)多不均勻；非腫瘤性腦出血組中,10例高血壓腦出血和3例單純性腦出血信號(hào)與腦腫瘤出血相比較均勻。3例動(dòng)靜脈畸形出血可見流空血管信號(hào)；5例海綿狀血管瘤出血可見“爆米花征”、“鐵環(huán)征”；2例靜脈血管畸形出血可見粗大的引流靜脈和多發(fā)髓靜脈,其中1例呈典型的“海蛇頭”征象；1例混合型血管畸形出血,兼具“爆米花征”、“鐵環(huán)征”和增粗引流靜脈顯影。(3)SWI掃描示腦腫瘤出血病例組中,23例于病灶內(nèi)或病灶周圍可見低信號(hào)腫瘤相關(guān)靜脈；3例未見明顯腫瘤相關(guān)靜脈。(4)CE-MR、SWI及CE-MR與SWI聯(lián)合應(yīng)用對(duì)腦腫瘤出血和非腫瘤性腦出血的鑒別診斷正確率進(jìn)行兩兩比較,CE-MR與SWI聯(lián)合應(yīng)用確診率高,優(yōu)于CE-MR和SWI方法單獨(dú)應(yīng)用。 結(jié)論(1)SWI能夠顯示腫瘤相關(guān)靜脈,有助于對(duì)腦腫瘤出血的診斷；(2)在MR平掃的基礎(chǔ)上,聯(lián)合應(yīng)用CE-MR與SWI能夠提高腦腫瘤出血和非腫瘤性腦出血的鑒別診斷準(zhǔn)確率。
[Abstract]:Objective to investigate the features of magnetic sensitivity weighted weighted imaging (SWI) in cerebral tumor hemorrhage and non-tumor intracerebral hemorrhage. To compare the value of contrast-enhanced magnetic resonance imaging, CE 路magnetic resonance imaging and their combination in the differential diagnosis of cerebral tumor hemorrhage and intracerebral non-neoplastic hemorrhage. Methods from December 2011 to December 2013, 26 cases of brain tumor hemorrhage and 26 cases of non-neoplastic intracerebral hemorrhage confirmed by surgery, pathology or clinical follow-up were collected and examined by CE-MR-SWI. There were 12 cases of astrocytoma, 11 cases of metastatic tumor, 3 cases of oligodendrocytoma, 10 cases of hypertensive intracerebral hemorrhage and 3 cases of simple intracerebral hemorrhage in non-tumor intracerebral hemorrhage group, which included 12 cases of astrocytoma, 11 cases of metastatic tumor and 3 cases of oligodendrocytoma. 13 cases of vascular malformation hemorrhage (5 cases of cavernous hemangioma hemorrhage, 3 cases of arteriovenous malformation hemorrhage, 2 cases of venous malformation hemorrhage), Three cases of mixed vascular malformation hemorrhage were compared with the correct rate of CE-MRN SWI combined with CE-MR and SWI in the etiological diagnosis of intracerebral hemorrhage. Results 1) the morphology of cerebral hemorrhage was divided into focal hemorrhage type and nodular mass type. Irregular enhancement was observed at the edge of contrast enhancement. Mild enhancement was observed in 10 hypertensive intracerebral hemorrhage cases and 3 simple intracerebral hemorrhage cases in non-neoplastic intracerebral hemorrhage group. The enhancement morphology was similar to that of hematoma. (2) the signal intensity of hematoma was not uniform in patients with hemorrhage of brain tumor. Comparison of 10 hypertensive intracerebral Hemorrhage and 3 simple intracerebral Hemorrhage in Non-neoplastic intracerebral Hemorrhage Group. "Rice flower sign", "iron ring sign", 2 cases of venous vascular malformation bleeding can be seen thick drainage vein and multiple medullary vein, Among them, 1 case presented typical "sea snake head" sign and 1 case had mixed vascular malformation hemorrhage. Both "popcorn sign", "iron ring sign" and thickening drainage vein. SWI scan showed that in 23 patients with hemorrhage of brain tumor, hypointensity tumor associated vein was found in or around the lesion in 3 cases, and there was no obvious tumor-associated vein. CE-MR-MRI was found in 3 cases; and. The diagnostic accuracy of CE-MR combined with SWI in the differential diagnosis of cerebral tumor hemorrhage and non-tumor intracerebral hemorrhage was higher than that of CE-MR combined with SWI. It is better than CE-MR and SWI alone. Conclusion the combined use of CE-MR and SWI can improve the accuracy of differential diagnosis of cerebral tumor hemorrhage and non-neoplastic intracerebral hemorrhage on the basis of Mr plain scan.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.34;R445.2

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