【摘要】：目的：1.評價(jià)DWI與PWI在不同時(shí)期腦梗死中聯(lián)合應(yīng)用的價(jià)值。2.探討不同時(shí)期腦梗死灶A(yù)DC值及超、急性期不同位置ADC值的變化規(guī)律。3.探討不同時(shí)期腦梗死灶的FA值變化及其對腦白質(zhì)纖維束的影響。 方法：收集從2012年11月～2014年3月來我院就診的腦梗死患者63例，其中男性患者35例，女性28例;年齡區(qū)間為30～88歲，平均年齡為61.3歲。分別包括發(fā)病在6小時(shí)以內(nèi)超急性期的腦梗死患者8例，，6～72小時(shí)急性期的腦梗死患者12例，3～10天亞急性期的腦梗死患者25例，10天以上慢性期的腦梗塞患者18例。所有患者行MR常規(guī)T1flair、T2WI、T2flair、DWI、DTI、PWI掃描。逐個(gè)測量患側(cè)和對側(cè)相應(yīng)區(qū)域的ADC，患側(cè)和對側(cè)相應(yīng)區(qū)域的FA值，超、急性期患者梗死灶中心、邊緣和周圍ADC值，由兩名經(jīng)驗(yàn)豐富的影像科醫(yī)師判讀DWI與PWI圖的匹配情況以及DTT圖的白質(zhì)纖維束的受損情況。 結(jié)果：本研究中PWIDWI的病例數(shù)為16例，DWI≈PWI的病例數(shù)為44例，PWIDWI的病例數(shù)為3例。超急性期及急性期腦梗死患側(cè)ADC值較健側(cè)對應(yīng)區(qū)明顯降低；從超急性期至慢性期ADC值逐漸升高，部分亞急性期患者梗塞區(qū)平均ADC值與健側(cè)對應(yīng)區(qū)幾乎相同；慢性期平均ADC值與健側(cè)對應(yīng)區(qū)相比呈顯著增高。在超、急性期腦梗塞中心平均ADC值明顯低于周邊區(qū)。除超急性期外，其余各期腦梗死患側(cè)FA值均低于健側(cè)對應(yīng)區(qū)，慢性期腦梗死患側(cè)較健側(cè)對應(yīng)區(qū)降低最為明顯。DTT圖可清楚顯示腦白質(zhì)纖維束走行，其中患側(cè)白質(zhì)纖維束較對側(cè)無明顯改變者13例，表現(xiàn)為稀疏、略減少者17例，表現(xiàn)為明顯缺損中斷者33例。 結(jié)論：1.PWI與DWI相結(jié)合，可以提示缺血半暗帶的存在，指導(dǎo)臨床治療。2.病變區(qū)平均ADC值從急性到慢性期逐漸增加，慢性期顯著高于健側(cè)對應(yīng)的區(qū)。超急性期及急性期患者病灶中心區(qū)的平均ADC值顯著比周圍區(qū)低。3.FA值及DTT圖可以反映腦梗死灶腦白質(zhì)纖維束的損傷情況。
[Abstract]:Purpose 1. To evaluate the value of combined use of DWI and PWI in cerebral infarction at different stages. To explore the ADC value of cerebral infarction in different periods and the changes of ADC value in different locations in acute phase. To investigate the changes of FA in cerebral infarction and its effect on white matter fiber bundle. Methods: from November 2012 to March 2014, 63 patients with cerebral infarction were collected, including 35 males and 28 females, with an average age of 61.3 years. They included 8 patients with acute cerebral infarction within 6 hours and 72 hours of acute cerebral infarction. There were 12 patients with subacute phase and 25 patients with chronic cerebral infarction more than 10 days after the onset of 6 hours or less. There were 18 patients with chronic cerebral infarction. All the patients underwent Mr conventional T _ 1 flaircontrast T _ 2 WI _ I _ T _ 2 flair contrast DWI DTI PWI scan. The ADCs of the affected and contralateral regions, the FA values of the affected and contralateral regions, the ADC values of the infarct center, edge and periphery of the patients in the acute phase were measured one by one, and the FA values of the corresponding areas of the affected and contralateral sides were measured one by one. The match between DWI and PWI and the damage of white matter fiber bundle on DTT were interpreted by two experienced radiologists. Results: in this study, there were 16 cases of PWIDWI with DWI 鈮

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