Detection value of double inversion recovery sequence in cerebral white matter hyperintensities in patients with acute ischemic stroke
陈佳琦 1岳云龙 2付睿 3牛睿 1王志娟
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作者信息
1. 首都医科大学附属北京世纪坛医院神经内科，北京 100038
2. 首都医科大学附属北京世纪坛医院核磁共振室，北京 100038
3. 首都医科大学附属北京世纪坛医院全科医学科，北京 100038
折叠
摘要
目的 评价双反转恢复（DIR）序列对急性缺血性脑卒中患者脑白质高信号（WMH）的检测效果，并与T2WI、液体衰减反转恢复（FLAIR）序列进行对比。 方法 选择首都医科大学附属北京世纪坛医院神经内科自2018年11月至2021年3月收治的发病14 d内且存在WMH的73例急性缺血性脑卒中患者，采用MRI T2WI、FLAIR及DIR序列分别检测WMH。根据Fazekas量表评分将存在侧脑室旁白质高信号（PVWMH）及深部白质高信号（DWMH）患者分别分为轻度组（0~1分）及中重度组（≥2分）。比较T2WI、FLAIR及DIR序列检测的WMH体积，孤立病灶的信号强度、截面积、对比度的差异。 结果 （1）73例患者检出PVWMH，其中轻度组36例，中重度组37例。在中重度组患者中，与DIR序列比较，FLAIR序列检测的PVWMH体积较大，差异有统计学意义（P<0.05)；与FLAIR序列比较，T2WI序列检测的PVWMH体积较小，差异有统计学意义（P<0.05)。57例患者检出DWMH，其中轻度组44例，中重度组13例。无论是轻度组还是中重度组患者，与DIR序列比较，FLAIR、T2WI序列检测的DWMH体积较大，差异均有统计学意义（P<0.05)。（2）共检出孤立病灶60个，长径5.0~9.1 mm。与DIR序列比较，FLAIR、T2WI序列检测孤立病灶的截面积较大、信号强度较高、对比度较低，差异均有统计学意义（P<0.05)。与FLAIR序列比较，T2WI序列检测孤立病灶的信号强度、对比度较高，差异均有统计学意义（P<0.05)。 结论 DIR序列探测WMH效果优于FLAIR和T2WI序列。DIR序列与FLAIR、T2WI序列WMH不匹配区域提示可能存在WMH半暗带。 Objective To evaluate the detective effect of double inversion recovery (DIR) sequence on cerebral white matter hyperintensities (WMH) in patients with acute ischemic stroke, and compare with those of T2WI and FLAIR sequences. Methods Seventy-three acute ischemic stroke patients with WMH within 14 d of onset, admitted to Department of Neurology, Beijing Shijitan Hospital, Capital Medical University from November 2018 to March 2021, were chosen. MRI T2WI, FLAIR and DIR sequences were used to detect WMH. According to Fazekas scale, patients with periventricular white matter hyperintensities (PVWMH) or deep white matter hyperintensities (DWMH) were divided into mild group (score of 0-1) and moderate to severe group (scores≥2) the differences in WMH volume detected by T2WI, FLAIR and DIR sequences, and signal intensity, cross-sectional area and contrast of isolated lesions were compared. Results (1) Seventy-three patients were with PVWMH (36 into the mild group and 37 into the moderate to severe group) in patients from the moderate to severe group, PVWMH volume detected by FLAIR sequence was statistically larger compared with that by DIR sequence, and PVWMH volume detected by T2WI sequence was significantly smaller compared with that by FLAIR sequence (P<0.05). Fifty-seven patients were with DWMH (44 into the mild group and 13 into the moderate to severe group) the DWMH volume detected by FLAIR and T2WI sequences was significantly larger than that by DIR sequence (P<0.05). (2) A total of 60 isolated lesions were detected, ranged 5.0-9.1 mm in length isolated lesions enjoying significantly larger cross-sectional area, higher signal intensity, and lower contrast detected by FLAIR and T2WI sequences compared with those by DIR sequence (P<0.05) isolated lesions enjoying significantly higher signal intensity and contrast detected by T2WI sequence compared with those by FLAIR sequence (P<0.05). Conclusion DIR sequence enjoys better effect in detecting WMH than FLAIR and T2WI sequences the mismatch area of DIR sequence with FLAIR or T2WI sequences suggests WMH penumbra.
Abstract
Objective To evaluate the detective effect of double inversion recovery (DIR) sequence on cerebral white matter hyperintensities (WMH) in patients with acute ischemic stroke, and compare with those of T2WI and FLAIR sequences. Methods Seventy-three acute ischemic stroke patients with WMH within 14 d of onset, admitted to Department of Neurology, Beijing Shijitan Hospital, Capital Medical University from November 2018 to March 2021, were chosen. MRI T2WI, FLAIR and DIR sequences were used to detect WMH. According to Fazekas scale, patients with periventricular white matter hyperintensities (PVWMH) or deep white matter hyperintensities (DWMH) were divided into mild group (score of 0-1) and moderate to severe group (scores≥2) the differences in WMH volume detected by T2WI, FLAIR and DIR sequences, and signal intensity, cross-sectional area and contrast of isolated lesions were compared. Results (1) Seventy-three patients were with PVWMH (36 into the mild group and 37 into the moderate to severe group) in patients from the moderate to severe group, PVWMH volume detected by FLAIR sequence was statistically larger compared with that by DIR sequence, and PVWMH volume detected by T2WI sequence was significantly smaller compared with that by FLAIR sequence (P<0.05). Fifty-seven patients were with DWMH (44 into the mild group and 13 into the moderate to severe group) the DWMH volume detected by FLAIR and T2WI sequences was significantly larger than that by DIR sequence (P<0.05). (2) A total of 60 isolated lesions were detected, ranged 5.0-9.1 mm in length isolated lesions enjoying significantly larger cross-sectional area, higher signal intensity, and lower contrast detected by FLAIR and T2WI sequences compared with those by DIR sequence (P<0.05) isolated lesions enjoying significantly higher signal intensity and contrast detected by T2WI sequence compared with those by FLAIR sequence (P<0.05). Conclusion DIR sequence enjoys better effect in detecting WMH than FLAIR and T2WI sequences the mismatch area of DIR sequence with FLAIR or T2WI sequences suggests WMH penumbra.
关键词
脑白质高信号/双反转恢复序列/脑白质高信号半暗带
Key words
Cerebral white matter hyperintensity/Double inversion recovery/Cerebral white matter hyperintensity penumbra
万方数据