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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (11): 93-96.

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DWI诊断CO中毒迟发性脑病的应用价值

刘力,白旭   

  1. 天津环湖医院神经放射科, 天津 300060
  • 收稿日期:2011-04-12 出版日期:2011-11-10 发布日期:2011-11-10
  • 作者简介:刘力(1972- ),男, 副主任医师,主要从事神经放射学研究。

Application value of MR diffusion-weighted imaging(DWI) in the diagnosis of delayed encephalopathy after carbon monoxide poisoning

LIU Li, BAI Xu   

  1. Department of Neuroradiology, Tianjin Huanhu Hospital, Tianjin 300060, China
  • Received:2011-04-12 Online:2011-11-10 Published:2011-11-10

摘要:

目的   研究弥散加权成像(DWI)诊断CO中毒迟发性脑病的应用价值。方法   对31例CO中毒迟发性脑病患者均行MR DWI检查,MRI检查在CO中毒后15~90d内完成,DWI使用单次激发平面回波序列,TR=2900ms,TE=84ms,b值为0和1000s/mm2。通过常规MRI、DWI及ADC图评价脑室周围脑白质区信号改变,测量病变区ADC值并与正常信号区进行对比。结果   所有患者DWI序列均显示在双侧脑室周围脑白质区及半卵圆中心弥漫高信号影,显示范围与T2WI及Flair序列所显示范围相似,ADC图显示为轻度低信号或等信号,其平均ADC值均较T2WI及Flair序列显示正常的区域明显减低(P<0.05)。结论   脑白质区ADC值减低的程度和持续时间与患者临床进展过程有关,通过对ADC值的观察能对CO中毒迟发性脑病患者的临床进展过程及预后进行推测。

关键词: 磁共振成像;弥散加权成像;一氧化碳中毒;迟发性脑病

Abstract:

Objective   To investigate the application value of diffusion-weighted imaging (DWI) in diagnosing delayed encephalopathy after carbon monoxide(CO) poisoning. Methods   31 patients with delayed encephalopathy after CO poisoning were enrolled in this study. All of them underwent MR imaging 15-90 days after exposure to CO. DW images were acquired using a single-shot echoplanar imaging sequence in the transverse plane(TR/TE, 2900ms/84ms) with b values of 0 and 1000s/mm2. Conventional MR images, DWIs, and apparent diffusion coefficient(ADC) maps of lesions in the white matter were evaluated. ADC values in the white matter lesions were calculated and compared with normal white matter. Results   In all patients, DWIs showed bilateral areas of diffuse high signal intensity in the periventricular white matter and centrum semiovale, similar to areas shown on T2-weighted and FLAIR images. White matter lesions showed hypo-intensity or iso-intensity on ADC maps. Mean ADC values of the white matter lesions were significantly lower than those of the normal-looking white matter(P<0.05). Conclusion   The degree and duration of low ADC values in the white matter are correlated with the clinical course, which may enable us to predict development and prognosis of delayed encephalopathy after CO poisoning.

Key words:  Magnetic resonance imaging; Diffusion-weighted imaging; Carbon monoxide poisoning; Delayed encephalopathy

中图分类号: 

  • R816.1
[1] 何敬振1,侯照成2,张华3,马祥兴1,王青1. 针刺脑功能磁共振成像的可重复性研究[J]. 山东大学学报(医学版), 2013, 51(7): 45-49.
[2] 刘何鹏,李传福,尉从新,曾庆师,侯金文,冯德朝,郑金勇. SWI及DTI在弥漫性轴索损伤慢性期的应用价值[J]. 山东大学学报(医学版), 2010, 48(2): 146-149.
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