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目的探讨常规磁共振成像(MRI)特别是快速液体衰减翻转恢复序列(FLAIR)联合磁敏感加权成像(SWI)对多发性硬化(MS)的诊断价值。方法 50例MS患者行头颅MRI检查,观察扫描序列包括T_1加权(T_1WI)、T_2加权(T2WI)、FLAIR和SWI,观察病灶的形态、分布及信号改变,比较4种序列对病灶显示的数目情况。结果 FLAIR序列共检出病灶307个,T_1WI检出病灶201个,T_2WI检出病灶276个,SWI检出病灶102个。MS病灶主要分布于两侧侧脑室周围白质区及半卵圆中心,形态多呈圆形、卵圆形、斑片状。T_1WI呈低信号、T_2WI及FLAIR呈高信号,SWI呈等、稍高信号。SWI显示的102个病灶中有96个见伴行静脉或内部穿行静脉,61个病灶见环形低信号,余205个FLAIR显示的病灶区域,150个SWI显示有静脉穿行。结论对于MS病灶的检出,FLAIR序列明显优于其它3个序列,能敏感地显示脑室旁及皮层下等T_2WI较易漏诊病灶,SWI能敏感地显示病灶内部及伴行的静脉。两者联合应用能很好理解病灶的微循环特征,提高病灶的检出率、准确率。
Objective To investigate the diagnostic value of conventional magnetic resonance imaging (MRI), especially rapid fluid decay reversal recovery sequence (FLAIR) and magnetic susceptibility weighted imaging (SWI) in patients with multiple sclerosis (MS). Methods Fifty patients with MS underwent craniocerebral MRI. The scanning sequences including T 1 weighted (T 1WI), T 2 weighted (T2WI), FLAIR and SWI were observed. The morphology, distribution and signal changes of the lesions were observed. . Results There were 307 lesions detected in FLAIR sequence, 201 lesions detected on T_1WI, 276 lesions detected on T 2 WI and 102 lesions detected on SWI. MS lesions are mainly distributed in the lateral white matter around the lateral ventricle and the center of the semi-oval, mostly round, oval, patchy. T_1WI showed low signal, T_2WI and FLAIR showed high signal, SWI was equal, slightly higher signal. Sixty-six of the 102 lesions revealed by the SWI showed accompanying veins or internal veins, 61 lesions showed low annular signals, and more than 205 FLAIR showed lesions and 150 SWIs showed venous penetration. Conclusion For the detection of MS lesions, the FLAIR sequence is significantly better than the other three sequences. It can be sensitively showed that T_2WI in the periventricular and subcortical sites is more likely to miss the lesion, and SWI can sensitively display the lesion internal and accompanying veins. The combination of the two can well understand the microcirculation characteristics of the lesion and improve the detection rate and accuracy of the lesion.