CAJ | 학술논문

目的：探讨3．0T 磁共振（Magnetic Resonance Imaging，MRI）弥散加权成像 DWI（Diffusion Weighted Ima-ging）对高血压脑病（Hypertensive Encephalopathy）及急性期脑梗死的鉴别诊断价值。方法回顾性分析高血压脑病（HE）及急性期脑梗死各15例患者的常规 MRI 平扫及 DWI 图像，分别测量 HE 患者病灶区和急性期脑梗死患者病灶区的 ADC 值及 ADC 值变化范围，并进行统计学分析。结果（1）15例 HE 和15例急性脑梗死患者的 MRI 平扫图像均可见长 T1长 T2信号，其中15例 HE 病灶区 DWI 呈低或等信号，少部分不典型呈高信号，ADC 呈高信号；15例急性期脑梗死病灶区 DWI 全部为高信号，ADC 呈低信号。（2）HE 病灶的 ADC 值为（1．418±0．17）×10-3 mm2/s，明显高于急性期脑梗死病灶的 ADC 值（0．448±0．11）×10-3 mm2/s，差异具有统计学意义（P ＜0．05）。结论常规MRI 扫描无法区分高血压脑病及急性期脑梗死，而磁共振弥散加权成像作为一种简便易行的诊断方法，其 DWI 图像及 ADC 值测量在两者的鉴别诊断中有一定临床价值。
목적：탐토3．0T 자공진（Magnetic Resonance Imaging，MRI）미산가권성상 DWI（Diffusion Weighted Ima-ging）대고혈압뇌병（Hypertensive Encephalopathy）급급성기뇌경사적감별진단개치。방법회고성분석고혈압뇌병（HE）급급성기뇌경사각15례환자적상규 MRI 평소급 DWI 도상，분별측량 HE 환자병조구화급성기뇌경사환자병조구적 ADC 치급 ADC 치변화범위，병진행통계학분석。결과（1）15례 HE 화15례급성뇌경사환자적 MRI 평소도상균가견장 T1장 T2신호，기중15례 HE 병조구 DWI 정저혹등신호，소부분불전형정고신호，ADC 정고신호；15례급성기뇌경사병조구 DWI 전부위고신호，ADC 정저신호。（2）HE 병조적 ADC 치위（1．418±0．17）×10-3 mm2/s，명현고우급성기뇌경사병조적 ADC 치（0．448±0．11）×10-3 mm2/s，차이구유통계학의의（P ＜0．05）。결론상규MRI 소묘무법구분고혈압뇌병급급성기뇌경사，이자공진미산가권성상작위일충간편역행적진단방법，기 DWI 도상급 ADC 치측량재량자적감별진단중유일정림상개치。
Objective To evaluate the value of DWI in differential diagnosis of hypertensive encephalopathy and a-cute cerebral infarction.Methods Retrospectively analysis the MRI and DWI imagings of 15 cases of hypertensive en-cephalopathy and 15 cases of acute cerebral infarction patients.To calculate the ADC value and variation range of ADC value in both of hypertensive encephalopathy and acute cerebral infarction cases.Meanwhile,to do statistical analysis. Results (1)The MRI imagings in 15 cases of HE and 15 cases of acute cerebral infarction showed long T1 and long T2 signals,15 cases of HE lesion in DWI showed low signal or isointensity,a few atypical showed high signal,ADC showed high signal;15 cases of acute cerebral infarction in DWI were all high signal,ADC showed low signal.(2)ADC values of HE contralateral lesions were (1.418±0.17×10-3 mm2/s,which significantly higher than the acute cerebral infarc-tion(0.448±0.11)×10-3 mm2/s,the difference was statistically significant(P <0.05).Conclusion The routine MRI scaning can not distinguish between hypertensive encephalopathy and acute cerebral infarction,but diffusion weighted imaging is simple as a diagnostic method,the DWI image and ADC value measurement has a certain clinical value in the differential diagnosis of hypertensive encephalopathy and acute cerebral infarction.