血红蛋白演变与MRI信号—培训课件.pptVIP

* 磁共振上T2象血肿周边低信号为脱氧血红蛋白，中心的 高信号为液体成分 在最初24小时，血肿中心呈液体－固体状，这是新鲜血肿的特点并且血红蛋白呈氧化状态。大多数非外伤性出血为动脉血，如动脉瘤破裂，高血压出血以及血管畸形出血。他们是反磁性的。他们开始时在血肿的中心没有T2的缩短。在超急性期能识别血肿中的氧合血红蛋白，是因为他们使T2延长。但这是没有特征性的。所以重要的识别脱氧血红蛋白的边界。血肿中心内要产生可见的T2缩短的脱氧血红蛋白的最小浓度有赖于磁场强度和成象技术。 所以在超急性期，氧合血红蛋白期信号： 1，T1加权上为低等信号。 2，T2加权上为高信号。机理为： a.血肿水分多 b.氧合血红蛋白具有反磁性。 * 静脉滥用毒品的37岁男性病人。在作T1加权和常TR多回波时死亡。 T1加权：死前象 PdWI,T2WI:死后象 * Small arrow: intracellular deoxyhemoglobin Curved arrow:thrombus（oxyhemoglobin). Oppen arrow:proteinaceous serum * Arrow: deoxyhemoglobin with surrounding vasogenic edema * FSE:more anterior hematoma turns dark,representing intracellular methemoglobin .posterior hematoma keeps the same signal as on T1WI,representing extracellular methemoglobin. On SE T2WI, hemosiderin has shown relatively lower signal ,reflexing greater magnetic susceptibility effects on conventional SE. Enhanced T1WI shows classic venous angioma with medusa’s head leading to central vein. * T2 relaxation time of a hematoma depends on its temporal phase (hyperacute: 0 to 24 hours; acute: 1 to 3 days; subacute: 3 to 14 days). In all phases, bulk magnetization of the extracellular space is the same (arrow of constant size). Bulk magnetization of the intracellular compartment, within intact red cells, changes during the evolution of the hematoma. Oxyhemoglobin during the hyperacute phase has low-induced magnetization because of its low magnetic susceptibility. This results in similar induced magnetization in the intracellular and extracellular environments such that water diffusing across the red cell membrane experiences a constant field. For this reason there is no dephasing caused by diffusion and therefore little T2 relaxation. During the acute phase, magnetically susceptible deoxyhemoglobin is formed, resulting in a higher magnetization within the red cell than in the surrounding extracellular space. The magnetic field gradient experienced by water molecules diffusing across the red cell membrane results