【摘要】 目的探讨MRI常规扫描及DWI诊断小儿自发性脑出血的价值及影像学特点。方法回顾性分析我院2016年2月至2019年5月80例自发性脑出血患儿临床资料,按临床分期包括超急性期15例,急性期20例,亚急性早期16例,亚急性晚期15例,慢性期14例,所有患儿均进行头部常规MRI序列及DWI扫描,并通过头颅CT证实,分析MRI常规扫描及DWI在不同时期自发性脑出血中的诊断价值。结果小儿自发性脑出血不同时期血肿灶T₁WI、T₂WI信号变化以及对应DWI图像信号改变具有明显的规律,超急性期表现为T₁WI等信号,T₂WI高信号,FLAIR高或等信号,DWI高信号;急性期表现为T₁WI等信号,T₂WI等信号,FLAIR低信号,DWI低信号;亚急性早期表现为T₁WI高信号,T2WI低或等信号,FLAIR低或等信号,DWI低信号;亚急性晚期表现为T₁WI高信号,T2WI高信号,FLAIR高信号,DWI高信号;慢性期表现为T1WI等-低信号,T2WI高或等信号,FLAIR混杂信号,DWI低信号。慢性期血肿ADC值高于亚急性晚期,亚急性晚期高于亚急性早期,亚急性早期高于急性期,急性期高于超急性期（P<0.05）;DWI扫描结果中ADC值鉴别慢性期与亚急性晚期脑出血ROC曲线下面积为0.924,高于亚急性晚期与亚急性早期（0.838）、亚急性早期与急性期（0.700）、急性期与超急性期（0.763,P<0.05）。结论不同时期小儿自发性脑出血MRI常规扫描及DWI诊断影像学征象存在差异,DWI在鉴别不同时间脑血肿具有较高的诊断效能。更多还原

【Abstract】 Objective To explore the value and imaging features of MRI routine scan and DWI in the diagnosis of spontaneous intracerebral hemorrhage（SIH） in children.Methods A retrospective analysis was performed on the clinical data of 80 SIH children in the hospital during the period from February 2016 to May 2019.According to different clinical stages,there were 15 cases in the hyperacute stage,20 cases in an acute stage,16 cases in the early subacute stage,15 cases in the late subacute stage,and 14 cases in chronic stage.All children underwent routine MRI sequences and DWI scans on the head,confirmed by head CT.The diagnostic value of MRI routine scan and DWI in SIH during different periods was analyzed.Results During during different periods of SIH,there were significa nt rules in the changes of T₁WI and T₂WI signals and the corresponding DWI image signals in the hematoma lesions.The hyperacute stage showed equal signal on T₁WI,high signal on T₂WI,high or equal signal on FLAIR and high signal on DWI.The acute stage showed an equal signal on T₁WI,a high signal on T₂WI,low signal on FLAIR and low signal on DWI.The early subacute stage showed a high signal on T₁WI,low or equal signal on T₂WI,low or equal signal on FLAIR and low signal on DWI.The late subacute stage showed a high signal on T₁WI,high signal on T₂WI,high signal on FLAIR and high signal on DWI.The chronic stage showed equal-low signal on T₁WI,high-equal signal on T₂WI,a mixed signal on FLAIR,and a low signal on DWI.ADC value of hematoma was the highest in the chronic stage,followed by late subacute stage,ea rly subacute stage,acute stage,and hyperacute stage（P<0.05）.In DWI sca n results,the a rea under the ROC curve（AUC） of ADC value was the highest in identifying cerebral hemorrhage between chronic stage and late subacute stage（0.924）,followed by that between late subacute stage and ea rly subacute stage（0.838）,between ea rly subacute stage and acute stage（0.700） and between acute stage and superacute stage（0.763）（P<0.05）.Conclusion There are differences in imaging signs of children with SIH during different periods between MRI routine sca ns and DWI.DWI is of relatively higher diagnostic efficiency in identifying cerebral intracerebral during different periods.更多还原