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目的探讨EPI弥散加权成像在诊断早期局灶性脑梗死中的价值,为临床早期治疗提供可靠的依据。方法85例临床可疑为脑卒中患者,24h内行CT检查,排除了颅内出血性疾患,随即行常规MRI及EPI弥散加权成像。结果上述85例患者中78例为早期局灶性脑梗死,病灶直径最小者约2.5mm,最大者20mm左右,其中脑质内合并其它病灶者46例,CT诊断与DWI无一例相符,常规MRI检查发现梗死病灶位置和数目与DWI完全相符者13例;另32例脑质内不合并其它病灶,CT怀疑缺血性病灶区域与DWI相符者9例,常规MRI检查发现梗死病灶位置和数目与DWI完全相符者23例。结论对于临床怀疑脑卒中患者,在行CT检查排除了脑出血后,结合常规MRI,行平面回波成像(EPI)序列弥散加权成像(DWI),可快速、准确地诊断早期局灶性脑梗死,值得推广应用。
Objective To investigate the value of EPI diffusion weighted imaging in the diagnosis of early focal cerebral infarction and provide a reliable basis for early clinical treatment. Methods Totally 85 patients with clinically suspected stroke were examined by computed tomography (CT) at 24 hours, and intracranial hemorrhagic disorders were excluded. Conventional MRI and EPI diffusion weighted imaging were performed immediately thereafter. Results Among the 85 patients, 78 were early focal cerebral infarction. The diameter of lesion was about 2.5mm and the maximum was about 20mm. There were 46 cases with intracranial lesions and other lesions. CT diagnosis was consistent with no DWI. Conventional MRI In the other 32 cases, there were no other lesions in the brain, and 9 cases were suspected to have ischemic lesions in the ischemic area of CT and DWI. The location and number of infarction lesions were found in conventional MRI DWI exactly matched in 23 cases. Conclusions In patients with clinically suspected stroke, CT scans exclude cerebral hemorrhage and combined with conventional MRI and EPI diffusion-weighted imaging (DWI) can rapidly and accurately diagnose early focal cerebral infarction , It is worth promoting application.