基底节区脑出血MRI影像学表现及其与CT对比分析
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摘要
目的分析基底节区脑出血磁共振成像(MagneticResonanceImaging,MRI)影像学表现及其与计算机断层扫描(computedtomography,CT)的对比。方法选取我院收治的50例基底节区脑出血患者纳入观察,并取同期50例急性脑梗死患者纳入对照组,均行MRI与CT检查,观察2组MRI影像学表现特点,并与CT对比。结果观察组病灶周围DWI高信号水肿带30例(60.00%),显著多于对照组6例(12.00%);观察组病灶DWI低信号与混杂信号所占比例明显高于对照组(P<0.05),高信号所占比例明显低于对照组(P<0.05);MRI示,2组点状、胼胝体所占比例比较无明显差异(P>0.05),观察组类圆形病变所占比例明显高于对照组(P<0.05),不规则形病变所占比例明显低于对照组(P<0.05);CT示观察组:CT值:(60-90)HU,病灶密度:不均匀增加或者呈均匀一致,水肿情况:血肿周围产生低密度水肿,病灶形态:主要为肾形,占位效应:3-5d逐渐产生占位效应;对照组:CT值:(60-80)HU,病灶密度:密度减低,水肿情况:局部产生脑水肿,病灶形态:主要为椭圆形或者圆形,占位效应:3～10d产生明显占位效。结论 MRI与CT均能准确诊断基底节区脑出血,MRI主要鉴别病灶形态、DWI序列信号;CT主要鉴别病灶密度与形态、CT值变化、水肿情况与占位效应。
Objective To analyze the magnetic resonance imaging(MRI)findings of cerebral hemorrhage in basal ganglia and comparison with computed tomography(CT).Methods A total of 50 patients with cerebral hemorrhage in basal ganglia were included in the observation group and 50 patients with acute cerebral infarction were included in the control group.All of them were examined with MRI and CT.MRI findings of both groups were observed and compared with CT.Results There were 30 cases(60.00%)with DWI high signal edema zone in the observation group,significantly more than those in the control group[6 cases(12.00%)].The proportions of DWI low signal and mixed signal in the observation group were significantly higher than those in the control group(P<0.05),and the proportion of high signal was significantly lower than that in the control group(P<0.05).MRI showed that there was no significant difference between the two groups in punctiform or corpus callosum(P>0.05).The proportion of quasi-circular shape in the observation group was significantly higher than that in the control group(P<0.05),while the proportion of irregular shape was significantly lower than that in the control group(P<0.05).CT showed that the CT value in observation group was(60-90)HU,the density of lesions was uneven increase or uniform,there was low-density edema around the hematoma,the morphology of lesions mainly was kidney-shaped,and mass effect gradually occurred at 3-5 days.The CT value of control group was(60～80)HU,the density of lesions decreased,there was local cerebral edema,the morphology of lesions mainly was elliptical or round,and obvious mass effect occurred at 3 to 10 days.Conclusion MRI and CT can accurately diagnose cerebral hemorrhage in basal ganglia.MRI mainly distinguishes the morphology and DWI sequence signal of lesions while CT mainly identifies the density,morphology,CT value change,edema and mass effect of lesions.
Objective To analyze the magnetic resonance imaging(MRI)findings of cerebral hemorrhage in basal ganglia and comparison with computed tomography(CT).Methods A total of 50 patients with cerebral hemorrhage in basal ganglia were included in the observation group and 50 patients with acute cerebral infarction were included in the control group.All of them were examined with MRI and CT.MRI findings of both groups were observed and compared with CT.Results There were 30 cases(60.00%)with DWI high signal edema zone in the observation group,significantly more than those in the control group[6 cases(12.00%)].The proportions of DWI low signal and mixed signal in the observation group were significantly higher than those in the control group(P<0.05),and the proportion of high signal was significantly lower than that in the control group(P<0.05).MRI showed that there was no significant difference between the two groups in punctiform or corpus callosum(P>0.05).The proportion of quasi-circular shape in the observation group was significantly higher than that in the control group(P<0.05),while the proportion of irregular shape was significantly lower than that in the control group(P<0.05).CT showed that the CT value in observation group was(60-90)HU,the density of lesions was uneven increase or uniform,there was low-density edema around the hematoma,the morphology of lesions mainly was kidney-shaped,and mass effect gradually occurred at 3-5 days.The CT value of control group was(60～80)HU,the density of lesions decreased,there was local cerebral edema,the morphology of lesions mainly was elliptical or round,and obvious mass effect occurred at 3 to 10 days.Conclusion MRI and CT can accurately diagnose cerebral hemorrhage in basal ganglia.MRI mainly distinguishes the morphology and DWI sequence signal of lesions while CT mainly identifies the density,morphology,CT value change,edema and mass effect of lesions.
引文
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[11]王锦程,徐浩力,刘帅良,等.亚急性期基底节区脑出血的CT灌注表面通透性探讨[J].中华神经科杂志,2017,50(3):201-207.
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[13]刘明蓉,李立为,张东友.基底节区脑出血患者急诊的CT表现及手术选择分析[J].中国CT和MRI杂志,2016,14(4):14-16.
[2]Wang,Xia,Arima,Hisatomi,Yang,Jie,et al.Mannitol and Outcome in Intracerebral Hemorrhage Propensity Score and Multivariable Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2 Results[J].Stroke:A Journal of Cerebral Circulati on,2015,46(10):2762-2767.
[3]冯阳,张超,文泽贤,等.基底节区脑出血并发肺部感染的危险因素分析[J].重庆医学,2016,45(7):890-892.
[4]袁明贤,吕田明.脑出血患者血肿“管涌现象”的磁敏感加权成像研究[J].新医学,2017,48(12):849-852.
[5]杨少峰,王宝华,王中.CT定位下微创小骨窗血肿清除术治疗老年高血压基底节区脑出血短期疗效观察[J].河北医学,2016,22(12):2034-2036.
[6]崔永华,夏咏本,虞正权.高血压性基底节区脑出血的CT分型及手术策略[J].中国现代医学杂志,2017,27(3):139-141.
[7]郑念东,张道宝,万晓强,等.应用CT灌注成像预测基底节区高血压脑出血术后近期预后的研究[J].实用医院临床杂志,2016,13(2):95-96.
[8]韩高飞.CT影像特征在高血压脑出血患者预后评估中的应用研究[J].陕西医学杂志,2017,46(12):1700-1701.
[9]高永开,GAOYong-kai.脑出血手术患者预后的CT影像学评估分析[J].中国CT和MRI杂志,2016,14(6):16-18.
[10]李天金,刘庆华.基底节区高血压脑出血应用螺旋CT检查术后血吸收程度的效果分析[J].中国CT和MRI杂志,2017,15(6):15-17.
[11]王锦程,徐浩力,刘帅良,等.亚急性期基底节区脑出血的CT灌注表面通透性探讨[J].中华神经科杂志,2017,50(3):201-207.
[12]周坦峰,吴伟.早期脑出血MRI影像特征及其诊断价值[J].中国CT和MRI杂志,2017,15(3):13-15.
[13]刘明蓉,李立为,张东友.基底节区脑出血患者急诊的CT表现及手术选择分析[J].中国CT和MRI杂志,2016,14(4):14-16.