Abstract:

Objective　To explore the application value of susceptibility weighted imaging (SWI) combined with diffusion weighted imaging (DWI) in the diagnosis of acute cerebral hemorrhage, so as to provide basis for early detection of hemorrhage focus in clinical and prevent secondary hemorrhage and other serious diseases. Methods　A total of 82 patients with suspected cerebral hemorrhage in The People's Hospital of Ruichang from July 2020 to April 2022 were selected, including 48 males and 34 females, aged (64.32±2.85) years. The SWI and DWI examinations were performed after admission, and the diagnostic results of SWI and DWI alone and in combination were statistically compared with the CT examination results as the gold standard. The imaging features of SWI and DWI in acute cerebral hemorrhage during different time periods were observed. Independent sample t test and χ² test were used for statistical analysis. Results　The results of CT examination showed that 53 of 82 patients with suspected cerebral hemorrhage in the acute phase were diagnosed, and the other 29 patients were diagnosed as acute cerebral infarction. When the onset of cerebral hemorrhage was <6 hours, 6-12 hours, and >12-24 hours, the apparent diffusion coefficients (ADC) [(3.62±0.53) ×10⁴ vs. (6.24±0.85) ×10⁴, (3.42±0.59) ×10⁴ vs. (5.86±0.74) ×10⁴, (3.61±0.68) ×10⁴ vs. (4.92±0.84) ×10⁴] and phase values (PV) [(-0.71±0.15) vs. (-0.32±0.08), (-0.68±0.21) vs. (-0.35±0.12), (-0.74±0.18) vs. (-0.29±0.14)] of the patients with acute cerebral hemorrhage were lower than those of the patients with acute cerebral infarction (t=17.189, 16.341, 7.665, 13.002, 7.782, and 11.659; all P<0.001). Taking acute cerebral hemorrhage as positive cases, 39 cases were positive on DWI, 42 cases were positive on SWI, and 52 cases were positive on the combination of DWI and SWI. Compared with those of DWI and SWI alone, the sensitivity and accuracy of the combined diagnosis were higher by 92.45% (49/53) and 91.46% (75/82), and the missed diagnosis rate was lower by 7.55% (4/53), with statistically significant differences (χ²=9.952, 7.408, and 9.952; all P<0.05). Conclusions　SWI and DWI can be used in the clinical diagnosis of acute cerebral hemorrhage. The combination of SWI and DWI can effectively improve the early detection rate of acute cerebral hemorrhage, provide a basis for early clinical screening and diagnosis, and formulating targeted interventions to improve the prognosis.

Key words:

Susceptibility weighted imaging, Diffusion weighted imaging, Acute cerebral hemorrhage, Diagnostic value

摘要：

目的　探讨磁敏感加权成像（SWI）联合弥散加权成像（DWI）在诊断脑出血急性期中的应用价值，以期为临床早期检出出血灶提供依据，防止二次出血等严重病症发生。方法　选取2020年7月至2022年4月就诊于瑞昌市人民医院的疑似脑出血急性期患者82例，其中男48例，女34例，年龄（64.32±2.85）岁。入院后均行SWI、DWI检查，以CT检查结果为金标准，统计比较SWI、DWI单独、联合诊断结果，观察脑出血急性期不同时间段SWI、DWI影像学特征，分析其诊断价值。统计学方法采用独立样本t检验、χ²检验。结果　经CT检查结果显示，82例疑似脑出血急性期患者中确诊53例，另29例确诊为急性脑梗死；脑出血急性期患者发病<6 h、6～12 h、>12～24 h内表观弥散系数（ADC）［（3.62±0.53）×10⁴比（6.24±0.85）×10⁴、（3.42±0.59）×10⁴比（5.86±0.74）×10⁴、（3.61±0.68）×10⁴比（4.92±0.84）×10⁴］、相位值（PV）［（-0.71±0.15）比（-0.32±0.08）、（-0.68±0.21）比（-0.35±0.12）、（-0.74±0.18）比（-0.29±0.14）］均低于急性脑梗死患者（t=17.189、16.341、7.665、13.002、7.782、11.659，均P<0.001）；以脑出血急性期为阳性标本，DWI诊断结果显示阳性39例，SWI诊断结果显示阳性42例，DWI、SWI联合诊断结果显示阳性52例；与DWI、SWI检查单独诊断比较，二者联合诊断灵敏度92.45%（49/53）、准确度91.46%（75/82）较高，漏诊率7.55%（4/53）较低，差异均有统计学意义（χ²=9.952、7.408、9.952，均P<0.05）。结论　SWI、DWI均可用于脑出血急性期临床诊断中，二者联合应用可有效提高脑出血急性期早期检出率，为临床早期筛查诊断提供依据，以针对性制定干预措施，改善预后。

关键词:

磁敏感加权成像, 弥散加权成像, 脑出血急性期, 诊断价值