CAJ | 학술논문

目的：探讨磁敏感加权成像（ SWI）在大面积脑梗死患者中的应用价值。方法选取20例诊断明确的大面积脑梗死的患者，给予及时入院（发病48 h内）患者NIHSS评分、SWI检查；未及时入院的患者（发病48 h至6 d）但有CT影像确诊的患者仅给予NIHSS评分。发病1周后，全部患者行SWI及CT检查并再次行NIHSS评分，并与之前的CT或SWI进行对比。结果本组20例患者中，12例（60％）于发病时检测出自发性出血，1周后复查发现17例（85％）有自发性出血。8例未及时入院的患者中3例（37．5％）于发病时行CT检查时隐约可见出血，1周后行SWI检查发现7例（87．5％）出血。经分析，老年人大面积脑梗死后的出血程度与NIHSS评分成正相关（rs ＝0．740，P＝0．0005）。 SWI与CT对大面积脑梗死检测出出血进行分析（P入院时＝0．113，P1周后＜0．05），显示SWI用于大面积脑梗死出血检测要优于CT检查。结论 SWI技术相比于CT在应用于大面积脑梗死后自发性出血的检测更为敏感，对治疗大面积脑梗死患者时出现再灌注损伤提供有力的影像诊断依据。
목적：탐토자민감가권성상（ SWI）재대면적뇌경사환자중적응용개치。방법선취20례진단명학적대면적뇌경사적환자，급여급시입원（발병48 h내）환자NIHSS평분、SWI검사；미급시입원적환자（발병48 h지6 d）단유CT영상학진적환자부급여NIHSS평분。발병1주후，전부환자행SWI급CT검사병재차행NIHSS평분，병여지전적CT혹SWI진행대비。결과본조20례환자중，12례（60％）우발병시검측출자발성출혈，1주후복사발현17례（85％）유자발성출혈。8례미급시입원적환자중3례（37．5％）우발병시행CT검사시은약가견출혈，1주후행SWI검사발현7례（87．5％）출혈。경분석，노년인대면적뇌경사후적출혈정도여NIHSS평분성정상관（rs ＝0．740，P＝0．0005）。 SWI여CT대대면적뇌경사검측출출혈진행분석（P입원시＝0．113，P1주후＜0．05），현시SWI용우대면적뇌경사출혈검측요우우CT검사。결론 SWI기술상비우CT재응용우대면적뇌경사후자발성출혈적검측경위민감，대치료대면적뇌경사환자시출현재관주손상제공유력적영상진단의거。
Objective To study the application value of susceptibility weighted imaging ( SWI) in massive cerebral infarction. Methods The head and the clinical manifestation of 20 patients with clear massive cerebral infarction were diagnosed by CT or MRI.Patients with timely admission(48 hours of onset) were treated with NIHSS scores,SWI check.Patients without timely admission(48 hours to 6 days from onset) with CT imaging diagnosis were treated only with the NIHSS score.A week after the incidence,all patients underwent SWI and CT examination and again for the NIHSS score, which was compared with the previous CT or SWI.Results Of the 20 patients, spontaneous bleeding was detected in 12 cases (60%) in the pathogenesis,and it appeared in 17 cases (85%) in reexamination a week later.Faintly visi-ble hemorrhage appeared in 3 patients (37.5%) out of the 8 cases without timely admission in the pathogenesis of CT inspection,and bleed-ing was found in 7 patients (87.5%) underwent SWI examination in the check one week later.The degree of bleeding was positively correla-ted with NIHSS score after old people's extensive cerebral infarction (rs=0.740,P=0.0005).When SWI and CT were use in the detection of hemorrhage in massive cerebral infarction (P =0.113 on admission and after admission,P <0.05) showed that SWI applied in massive cer-ebral infarction hemorrhage detection was superior to CT detection.Conclusion Compared with SWI,CT can more effectively reflect the situ-ation of massive cerebral infarction patients accompanied by bleeding,giving imaging evidence for the treatment of large area cerebral infarc-tion and the reperfusion injury.