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目的探讨弥散加权成像(DWI)在脑干梗死诊断中的应用价值。方法 100例脑干梗死患者,同时合并其他脑内梗死或陈旧性梗死者73例。全部病例行常规DWI轴位扫描,其中24例采用弥散全方向成像,76例采用单方向成像。结果全部成功行DWI检查。超急性期4例仅在DWI上显示梗死灶;急性期梗死灶对比更加清晰,病变范围较T2加权成像(T2WI)扩大;亚急性期DWI上病灶显示仍呈高信号,与T2WI及T2WI液体衰减反转恢复序列(T2FLAIR)显示大小相仿;慢性期(陈旧性梗死)软化灶DWI显示为低信号。中脑和桥脑梗死急性期病灶边缘模糊;延髓梗死灶局限于单侧,边缘清晰。结论 DWI技术可以更早地检查出脑干梗死灶,明确病灶范围,并推测其新鲜程度。单方向DWI扫描检查时间明显缩短,可减少运动伪影,适用于急重症患者的检查。
Objective To investigate the value of diffusion-weighted imaging (DWI) in the diagnosis of brainstem infarction. Methods 100 cases of brain stem infarction patients, combined with other cerebral infarction or infarction in 73 cases. All patients underwent routine DWI axial scanning, of which 24 cases were diffuse omnidirectional imaging, 76 cases using unidirectional imaging. Results All successful DWI examination. In the hyperacute stage, only 4 cases showed infarction on DWI. The contrast of infarction in acute stage was more clear, and the range of lesions was more obvious than that of T2 weighted imaging (T2WI). In subacute stage, lesions on DWI showed high signal and attenuated with T2WI and T2WI Reverse recovery sequence (T2FLAIR) showed similar size; chronic phase (old infarction) DWI showed low signal. Mild cerebral infarction and infarct lesions in the acute edge of blur; infarct limited to unilateral bulging, clear edge. Conclusions The DWI technique can detect infarction in brainstem earlier, clarify the extent of lesion, and speculate on its freshness. Unidirectional DWI scan significantly shorter examination time, can reduce the movement artifacts, for critically ill patients check.