DWI对超急性期脑梗塞的诊断价值

摘要：目的  探討磁共振弥散加权成像（DWI）对超急性期脑梗塞的诊断价值。方法  收集2018年1月～2019年3月本院接收的40例经脑血管造影确诊且行DWI扫描的急性脑梗塞患者临床资料，比较急性期与超急性期患者的肿瘤表观扩散系数（ADC），分析DWI对超急性期脑梗塞的检出率及诊断价值。结果  超急性期脑梗塞患者的患侧ADC值高于急性期患者，差异有统计学意义（P<0.05）。40例患者中有26例诊断为超急性期患者，诊断符合率为92.86%（26/28）;11例诊断为急性期，符合率为91.67%（11/12）。DWI诊断超急性期脑梗塞的灵敏度为92.86%、特异度为91.67%、准确度为92.50%、阳性预测值为96.30%、阴性预测值为84.61%。结论  DWI诊断超急性期脑梗塞可准确显示其病灶，具有较高灵敏度、特异度及准确度，可为临床治疗提供重要参考依据。

关键词：超急性期;脑梗塞;磁共振弥散加权成像;肿瘤表观扩散系数;诊断价值

中图分类号：R743.33                                 文献标识码：A                               DOI：10.3969/j.issn.1006-1959.2020.14.057

文章编号：1006-1959（2020）14-0172-02

The Diagnostic Value of DWI in Hyperacute Cerebral Infarction

WANG Hao

（Department of Imaging，the First People's Hospital of Jiujiang City，Jiujiang 332000，Jiangxi，China）

Abstract：Objective  To explore the value of magnetic resonance diffusion weighted imaging （DWI） in the diagnosis of hyperacute cerebral infarction. Methods  The clinical data of 40 patients with acute cerebral infarction diagnosed by cerebral angiography and DWI scans received in our hospital from January 2018 to March 2019 were collected， and the tumor apparent diffusion coefficient （ADC） of patients in the acute phase and hyperacute phase was compared，to analyze the detection rate and diagnostic value of DWI for hyperacute cerebral infarction.Results  The ADC value on the affected side of patients with hyperacute cerebral infarction was higher than that of patients with acute phase，the difference was statistically significant （P<0.05）. Of the 40 patients， 26 were diagnosed as hyperacute patients， and the diagnostic coincidence rate was 92.86% （26/28）; 11 patients were diagnosed as acute， with a coincidence rate of 91.67% （11/12）. The sensitivity of DWI to diagnose hyperacute cerebral infarction was 92.86%， specificity was 91.67%， accuracy was 92.50%， positive predictive value was 96.30%， and negative predictive value was 84.61%.Conclusion  DWI diagnosis of hyperacute cerebral infarction can accurately display its focus， with high sensitivity， specificity and accuracy， and can provide an important reference for clinical treatment.

Key words：Hyperacute stage;Cerebral infarction;Magnetic resonance diffusion-weighted imaging; Tumor apparent diffusion coefficient;    Diagnostic value

脑梗塞（cerebral infarction）是因脑部血液供应障碍，缺血或缺氧所导致的局限性脑组织的缺血性坏死，多发于45岁以上的中老年群体。常见的临床症状包括头痛、头晕、恶心呕吐、半身不遂等，对患者身心健康及生活质量造成严重影响。超急性期脑梗塞是指发病时间在6 h之内的脑梗死，具有较高致残率及致死率，临床治疗需根据不同病理周期制定针对性方案，以提高患者生存率，改善预后，因此，对脑梗塞患者进行科学有效的分期诊断十分重要。常规的头颅磁共振（MRI）诊断早期脑梗死敏感度较低，诊断效果并不理想;磁共振弥散加权成像（DWI）可有效反映出分子水平的弥散状态，超急性期脑梗塞在DWI诊断中会出现异常信号，价值较高[1]。鉴于此，本研究分析了DWI对超急性期脑梗塞的诊断价值，现报道如下。

1资料与方法

1.1一般资料  收集2018年1月～2019年3月九江市第一人民医院接收的40例经脑血管造影确诊且行DWI扫描的急性脑梗塞……