【摘要】 目的探讨磁敏感加权成像(SWI)技术在急性大脑中动脉(MCA)闭塞机械取栓术后的临床应用价值。方法采用Solitaire AB支架机械取栓术治疗急性MCA闭塞的患者21例。患者发病到治疗时间4-7h。均成功取栓,脑血管造影显示MCA开通;取栓结束术中即刻行DynaCT示颅内无出血灶;取栓术后1、3、7d行CT、MRI及SWI检查,分析常规CT、MRI与SWI检查在显示病变微出血中的差异。结果 21例患者中,术后第3天SWI检出脑微出血16例,表现为点状、条状、类圆形或环形的低信号影;而术后第1天行头颅CT检出脑微出血3例,术后第3天MRI检出脑微出血8例。结论 SWI技术在诊断脑微出血灶方面优于常规序列,可以指导急性MCA闭塞机械取栓术后的用药治疗,评价取栓术后的预后和治疗效果。更多还原

【Abstract】 Objective To evaluate the value of susceptibility-weighted imaging(SWI)after mechanical thrombectomy for acute middle cerebral artery(MCA)occlusion.Methods The mechanical thrombectomy by Solitaire AB stent was carried out in 21patients with acute MCA occlusion,who were operated in 4to 7hours after onset.The cerebral angiography after thrombectomy displayed that successful recanalization was obtained in MCA.There was no intracranial hemorrhage on DynaCT at the end of operation.The clinical results were evaluated with CT,MR and SWI examination on the 1st,3rd and 7th day after treatment.The difference of micro-bleeding in the lesions reported by conventional and SWI was compared.Results On the 3rd postoperative day,SWI sequences clearly exhibited the dot-,stripe-,round-or ring-shaped low signal shadows in 16patients.However,conventional CT detected 3cases of micro-bleeding on the 1st postoperative day and MRI detected 8cases of that on the 3rd postoperative day in the 21patients.Conclusion SWI has distinct advantages over the conventional sequence in the diagnosis of intracranial lesions of micro-bleeding,which can guide the medical treatment after the mechanical thrombectomy and provide imaging basis for evaluating the efficacy and prognosis.更多还原