血管周围间隙与腔隙性梗死灶的鉴别

发布时间：2018-05-15 05:10

本文选题：血管周围间隙 + 腔隙性梗死灶　；参考：《中国医学创新》2016年08期

【摘要】：目的:观察总结血管周围间隙和腔隙性梗死灶在磁共振上的表现特点,以鉴别两种疾病,提高确诊率。方法:选择经临床随访并证实的腔隙性脑梗死患者50例及血管周围间隙患者40例作为研究对象,综合对比分析其磁共振影像形态、大小、部位、边界、信号、占位效应等表现。结果:VRS在MRI上表现为边界清楚的圆形、卵圆形或线状、管状结构,与穿支血管走行一致,在T1WI为低信号,T2WI为高信号,FLAIR序列为低信号,无对比剂增强效应和占位效应。腔隙性梗死灶在T1WI呈低信号,T2WI呈高信号;在FLAIR序列上表达高信号,慢性期为低信号,周围可见薄边高信号影;在DWI急性期呈高信号,随时间推移信号减低,变为等信号、低信号,MRI增强扫描周围见轻度环形强化或无强化。结论:在磁共振影像上,可通过观察病灶信号、形态和序列等对血管周围间隙和腔隙性梗死灶进行鉴别诊断。
[Abstract]:Objective: to observe and summarize the MRI features of perivascular space and lacunar infarction in order to differentiate the two diseases and improve the diagnostic rate. Methods: 50 patients with lacunar cerebral infarction and 40 patients with perivascular space were selected as subjects. The MRI features such as shape, size, location, boundary, signal and space occupying effect were compared and analyzed. Results on MRI, the VRS showed circular, oval or linear, tubular structure, which was consistent with the perforating vessels. In T1WI, the hypointensity flair sequence was hypointensity on low signal T2WI, and there was no contrast enhancement effect or space occupying effect. The lacunar infarct showed high signal intensity on T1WI with low signal intensity on T _ 2WI, high signal intensity on FLAIR sequence, low signal intensity in chronic phase and high signal intensity around DWI. In the acute phase of DWI, the signal intensity decreased with time and became isointense. Low-intensity Mr enhanced MRI showed mild circular enhancement or no enhancement around the scan. Conclusion: Mr imaging can be used to differentiate perivascular space and lacunar infarction by observing the signal, morphology and sequence of the lesions.
【作者单位】：中南大学湘雅二医院深圳医院(广东省深圳市蛇口人民医院);中南大学湘雅二医院;
【分类号】：R743.3

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