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目的比较常规磁共振(MRI)检查和弥散加权磁共振(DWI)检查技术对多发性硬化(MS)的诊断价值。方法采用美国GE公司生产的Signa 1.5T Twin Speed磁共振机对58例经临床与实验室检查明确的MS病例(男34例、女24例,平均年龄35.95岁),例行T1FLAIR、T2加权扫描(T2WI)及弥散加权成(DWI)像检查。将3种序列所见进行比较,同时使用软件进行DWI的弥散系数(ADC)值及影像分析。结果(1)MS病灶在MRI扫描中,T2WI像共发现病灶798个,T1FLAIR检见病灶673个,T1FLAIR显示的病灶数为T2WI的84%。采用DWI检查,可见病灶537个,检见病灶数为T2WI的67%。(2)T1FLAIR所检MS病灶的信号多为低或略低信号,T2WI的病灶显示为高信号,DWI在急性期病灶显示为略高信号影,在慢性期可表现为等信号或低信号。(3)MS急性期病灶平均ADC值与急性脑梗死相比无显著性差异(P>0.05)。亚急性和慢性期平均ADC值(0.001 05)高于脑缺血的ADC值(0.000 495)(P<0.001),但低于脑肿瘤的ADC值(0.001 74)(P<0.05)。结论常规磁共振的阳性检出率T2WI优于T1WI;DWI可以明确判定脑内白质区的MS病灶是否急性期,同时应用DWI、ADC图检查对判别病灶的性质,尤其对脑缺血性或肿瘤性病灶有较大帮助,是诊断MS等脱髓鞘疾病的有效影像学方法。
Objective To compare the diagnostic value of conventional magnetic resonance imaging (MRI) and diffusion weighted magnetic resonance (DWI) in the diagnosis of multiple sclerosis (MS). Methods Fifty-eight MS patients (34 males and 24 females, with an average age of 35.95 years) who had been clinically and laboratoryly identified by means of the Signa 1.5T Twin Speed magnetic resonance imaging machine manufactured by GE Company of USA were performed routine T1FLAIR and T2 weighted scans (T2WI) and diffusion weighted imaging (DWI) imaging. The three sequences were compared, and DWI diffusion coefficient (ADC) values and image analysis were performed simultaneously. Results (1) In the MRI scan, 798 T2WI lesions were found, 673 lesions were detected by T1FLAIR, and the number of lesions showed by T1FLAIR was 84% of T2WI. Using DWI examination, we can see 537 lesions, check the number of lesions to T2WI 67%. (2) The signals of MS lesions detected by T1FLAIR were mostly low or slightly low signal, T2WI lesions showed high signal, DWI showed slightly higher signal in acute phase and equal or low signal in chronic phase. (3) There was no significant difference in the average ADC value between MS acute stage and acute cerebral infarction (P> 0.05). The mean ADC value of subacute and chronic phases (0.001 05) was higher than that of cerebral ischemia (0.000 495) (P <0.001), but lower than that of brain tumors (0.001 74) (P <0.05). Conclusion The positive detection rate of conventional magnetic resonance T2WI is superior to T1WI. DWI can clearly determine whether the MS lesion in the white matter of the brain is acute or not. At the same time, DWI and ADC maps are used to determine the nature of the lesion, especially cerebral ischemia or tumor Lesions have greater help, is the diagnosis of demyelinating MS and other effective imaging methods.