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目的探讨MRI的梯度回波T2成像(GRET2WI)在蛛网膜下腔出血(SAH)诊断中的作用。方法对12例SAH患者进行CT和MRI的比较分析,MRI常规使用T1WI、T2WI、FLAIR和GRET2WI。结果(1)急性期SAH患者,48h内MRI检查FLAIR和GRET2WI均可见异常信号,而T1WI、T2WI检出率分别为66.6%和50.0%;(2)亚急性期(发病7～20d),CT已为阴性,MRI的T1WI、T2WI和FLAIR均不敏感(检出率为0～25.0%),GRET2WI仍可见信号丢失;(3)不典型SAH,腰穿显示阳性结果,CT和MRI的FLAIR序列均为阴性,GRET2WI可有阳性发现。结论MRI可应用于急性和亚急性SAH的诊断,其中GRET2WI是诊断SAH最敏感的序列,且对亚急性期和不典型SAH的诊断优于CT。
Objective To investigate the role of GRET2WI in the diagnosis of subarachnoid hemorrhage (SAH) by MRI gradient echo T2 imaging. Methods CT and MRI were compared in 12 patients with SAH. T1WI, T2WI, FLAIR and GRET2WI were used in MRI. Results (1) Abnormal signals were detected on FLAIR and GRET2WI in acute phase of SAH, but the detection rates of T1WI and T2WI were 66.6% and 50.0% respectively within 48 hours. (2) In the subacute stage (onset of 7-20 days), CT (3) atypical SAH, lumbar puncture showed a positive result, CT and MRI FLAIR sequence (detection rate was 0 ~ 25.0%), MRI still showed no signal T1WI, T2WI and FLAIR All were negative, GRET2WI positive findings. Conclusion MRI can be applied to the diagnosis of acute and subacute SAH. Among them, GRET2WI is the most sensitive sequence for diagnosis of SAH, and the diagnosis of subacute and atypical SAH is better than that of CT.