| 王娟,周义成,钟高贤,王承缘,夏黎明,朱文珍.DWI和MRS对微创血肿清除术后的评估研究[J].中国医学影像技术,2007,23(3):367~369 |
| DWI和MRS对微创血肿清除术后的评估研究 |
| DWI and MRS study for the intracerebral hemorrhage with micro-damage puncture |
| 投稿时间：2006-09-22 修订日期：2006-11-03 |
| DOI： |
| 中文关键词: 脑出血 弥散加权成像 磁共振波谱 |
| 英文关键词:Intracerebral hemorrhage Diffusion weighted imaging Magnetic resonance spectroscopy |
| 基金项目: |
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| 中文摘要: |
| 目的 观察脑出血患者保守治疗及微创血肿清除术治疗后DWI和MRS表现,探讨血肿周围脑组织改变及微创血肿清除术的临床价值。方法 20例高血压脑出血患者随机分为两组,微创血肿清除手术组(微创组)和保守治疗组(对照组)各10例,所有病例均于发病后9~11天行常规MR及DWI和MRS检查。结果 对照组和微创组血肿周围ADC值与对侧相应区ADC值的差异均有显著性差异(P<0.01),对照组血肿周围区域ADC值高于微创组(P<0.05)。MRS示对照组血肿周围NAA/Cr与对侧相应区的NAA/Cr值有显著性差异(P<0.01),前者较后者降低(12.6±7.4)％,其中4例可见到明确的乳酸峰。微创组血肿周围NAA/Cr与对侧相对应区的NAA/Cr值亦有统计学显著性差异(P<0.05),前者较后者降低(7.4±6.8)％。结论 血肿周围水肿ADC值升高,血管源性水肿占主导。MRS示血肿周围NAA/Cr降低,反映了血肿周围神经元损伤。微创血肿清除术能改善脑出血后脑水肿形成。 |
| 英文摘要: |
| Objective To observe the signs of the intracerebral hemorrhage (ICH) patient with conservative therapy and micro-damage puncture by diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS), trying to investigate the changes of brain tissue around hemorrhage and the clinical value of micro-damage puncture. Methods Twenty patients with ICH were divided into micro-damage puncture group (10 cases) and control group (10 cases) randomly. All patients were performed routine and functional MRI (DWI and MRS) examinations in the nine to eleven days after the symptom onset. Results The difference of the perihematomal apparent diffusion coefficient (ADC) value between the micro-damage puncture and the control group was significant (P<0.01), and the perihematomal ADC value of the control group was higher than the micro-damage puncture group (P<0.05). The difference of the perihematomal NAA/Cr value between the focus side and the contralateral corresponding side was significant in the control group(P<0.01), and the focus side decreased (12.6±7.4)％ as compared with the contralateral corresponding side, four could be seen the obvious Lac peak among all patients. There was no statistically significant difference in the perihematomal NAA/Cr value between the focus side and the contralateral corresponding side in the micro-damage puncture group (P<0.05), and the focus side decreased (7.4±6.8)％. Conclusion Edema ADC values increased, and vasogenic edema was the major information mechanism. MRS showed that the NAA/Cr decreased around hemorrhage. Under a certain premise it reflected the decrease of neurons around the hemorrhage. The micro-damage puncture could reduce the formation of brain edema after ICH. |
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