摘要
目的:探讨磁共振弥散加权成像(magneticresonancediffusionimaging,DW-MRI)评估急性脑梗死治疗后的缺血面积与临床疗效评价是否具有很好的一致性,能否反映治疗过程中病变脑组织的康复状态。方法:中国医科大学附属第一医院急诊科和神经内科住院治疗、符合《实用神经病学(第3版)》急性脑梗死诊断标准、排除脑出血、脑肿瘤、脑栓塞及短暂性脑缺血发作等疾病、发病超过6h的急性前循环脑梗死患者21例,分别于治疗前及治疗后6,12,24h、1周、1个月行DW-MRI扫描,并计算各个时间点的缺血最大层面的缺血面积及其扩大或缩小程度。同时于治疗前及治疗后1周、1个月进行神经功能缺损评定,评估疗效。结果:治疗后24h内缺血面积缩小者1例、无变化者5例、扩大者15例,治疗后1周、1个月缺血面积缩小者分别为5例、10例,无变化者分别为10例、8例,与相应临床疗效评价具有很好的一致性。结论:急性脑梗死经综合治疗后缺血面积的动态变化与临床疗效判定结果密切相关,DW-MRI可以作为其疗效判定的很好的影像学方法。
AIM:To explore whether the ischemic areas after therapy evaluated by using diffusion-weighted magnetic resonance imaging(DW-MRI)have a better concordance with the clinical effect in patients with acute cerebral infarction,and whether DW-MRI can reflect the rehabilitation state of the injured brain tissue during treatment.METHODS:Patients,who were treated in the Department of Emergency and Neurology,First Affiliated Hospital of China Medical University and in accordance with the diagnostic criteria of acute cerebral infarction of Practical Neurology(Third edition),were selected,and then those with cerebral hemorrhage,brain tumour,cerebral embolism,transient ischemic attack and acute anterior circulation cerebral infarction for more than 6 hours were excluded,so totally 21 patients were involved in the study.All the cases were screened serially with DW-MRI sequence before and 6,12,24 hours,1 week and 1 month after treatment.The ischemic areas of the maximum surface and the increasing or decreasing rate at each time point were calculated, neurologic impairment was assessed and curative effect was evaluated before and 1 week and 1 month after treatment respectively. RESULTS:There was 1 case with decreased ischemic areas,5 cases without changes and 15 cases with increased ischemic areas during the 24 hours after treatment.One week after treatment,5 cases with decreased ischemic areas and 10 cases without changes.One month after treatment,10 cases with decreased ischemic areas and 8 cases without changes.Ischemic areas were well coincident with the correspondent evaluation of clinical effect.CONCLUSION:The dynamic changes of ischemic areas after comprehensive therapy have a close correlation with the evaluation of clinical effect,and DW-MRI is a good imaging method for monitoring the therapeutic effect on acute cerebral infarction.
出处
《中国临床康复》
CSCD
2004年第25期5302-5303,共2页
Chinese Journal of Clinical Rehabilitation
