血管周围间隙与腔隙性梗死灶的鉴别_孙沄.pdfVIP

临床研究 Linchuangyanjiu　　《中国医学创新》第13 卷 第 8 期（总第 362 期）2016 年 3 月 血管周围间隙与腔隙性梗死灶的鉴别 孙沄①　莫信①　曾琼莉②　臧艳芬①　汤小俐①　黄海彬① 　　【摘要】　目的：观察总结血管周围间隙和腔隙性梗死灶在磁共振上的表现特点，以鉴别两种疾病， 提高确诊率。方法：选择经临床随访并证实的腔隙性脑梗死患者 50 例及血管周围间隙患者 40 例作为研 究对象，综合对比分析其磁共振影像形态、大小、部位、边界、信号、占位效应等表现。结果：VRS 在 MRI 上表现为边界清楚的圆形、卵圆形或线状、管状结构，与穿支血管走行一致，在 T1WI 为低信号， T2WI 为高信号，FLAIR 序列为低信号，无对比剂增强效应和占位效应。腔隙性梗死灶在 T1WI 呈低信号， T2WI 呈高信号；在 FLAIR 序列上表达高信号，慢性期为低信号，周围可见薄边高信号影；在 DWI 急性 期呈高信号，随时间推移信号减低，变为等信号、低信号，MRI 增强扫描周围见轻度环形强化或无强化。 结论：在磁共振影像上，可通过观察病灶信号、形态和序列等对血管周围间隙和腔隙性梗死灶进行鉴别 诊断。 　　【关键词】　血管周围间隙；　腔隙性梗死灶；　核磁共振技术；　鉴别诊断 　　Identification of Virchow-Robin Spaces and Lacunar Infarction/SUN Yun，MO Xin，ZENG Qiong- li，et al.//Medical Innovation of China，2016，13（08）：068-071 　　【Abstract】　Objective：To summarize the MRI features of Virchow-Robin spaces（VRS） and lacunar infarction （LI） for the differentiation of the two diseases and the improvement of diagnostic rate.Method：50 confirmed LI patients and 40 VRS patients were selected as the research objects.Their MRI features in respects of shape，size，position， boundary，signal and space occupying effect were compared and analyzed.Result：The VRS featured round，oval， linear or tubular shapes with clear boundary and it had the same direction with the perforator vessels.Their signals were low on T1WI，high on T2WI and low on FLAIR sequences without the enhancement effect of contrast agent and the space occupying effect.By contrast，the LI signals were low on T1WI，high on T2WI and high on FLAIR sequences，in chronic phase they were low signals surrounded by high signal zone with thin edge.In acute stage， the DWI featured high signals which decayed gradually to equal or low ones.The ring-like enhancement or no enhancement was visible with contrast-enhanced MRI scanning.Conclusion：VRS and