【摘要】 目的评价弥散成像（DWI）、血流灌注成像（PWI）磁共振对急性缺血性脑血管病的诊断价值。方法用DWI、PWI诊断急性脑缺血，并与常规MRI结果比较。结果经MRI检查证实的急性缺血性脑血管病患者共22例。其中发病后90分钟至6小时检查者11例，其CT及常规MRI未见异常，3例短暂性脑缺血发作（TIA）患者的DWI、PWI正常；其余8例脑梗死患者经DWI、PWI检查，均发现相对应的病灶，且6例灌注减低体积（PWIv）＞弥散异常体积（DWIv），2例PWIv＝DWIv。起病在6－12小时5例，4例行PWI检查，3例PWIv＞DWIv，1例PWIv＝DWIv。起病在12－48小时6例，2例行PWI检查，PWIv＝DWIv。8例陈旧病灶在DWI上表现为低信号，所有新病灶在DWI上均为高信号。结论DWI、PWI可超早期诊断脑梗死，并可帮助了解缺血半暗带。T2加权像和DWI结合可以鉴别新旧梗死灶。更多还原

【Abstract】 Objective To evaluate the role of MR diffusion-weighted imaging (DWI) and perfusionweighted imaging(PWI) in the diagnosis of acute ischmic cerebrovascular disease. Method DWI and PWI wereperformed on 22 patients with acute cerebral ischemia, and were compared with routine MRI. Results There were22 patients with acute ischemic cerebrovascular disease diagnosed by MRI. Eleven patients were in the hyperacutestag so that the ischemic lesion could not be detected with CT and routine MRI. Among those patients,3 of themwith transient ischemic attacks had DWI and PWI, whereas the other 8 patients with cerebral infarction wereidentified to be hyperacute ischemic lesions by DWI and PWI and the 6 patients’ abnormal perfusion regions werelarger than the hyperintense areas shown by DWI. Two patients’ abnormal perfusion rgeions were as large as thehyperintense areas shown by DWI. Five patients’ attacks occurred in 6 ~ 12 hours after the onset only foul patientshad PWI examinations performed,three patients abnormal perfusion regions were larger than the hyperintenseareas shown by DWI. One patient’s abnormal perfusion region was as large as the hyperintense areas shown byDWI. Six patients had their onset attacks in 12 ~ 48 hours. Only two of them had PWI examinations performed.The abnormal perfusion region was as large as the hyperintense areas shown by DWI. Eigh chronic lesions wereidentified as hyperintense regions in DWI. All early ischemic lesions were identified as hyperintense regions inDWI. Conclusion DWI and PWI can be used to diagnose hyperacute cerebral infarction, and to demonstrateischemic penumbrae and even to identify the leson’s stages.更多还原