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目的评价MRI、MRA对急性CO中毒伴发急性脑梗死的诊断价值。方法回顾分析15例经临床确诊的急性CO中毒伴发急性脑梗死患者的头颅MRI、MRA资料。结果15例患者急性脑梗死病变部位:MRI为点状、片状异常信号;DWI表现为高信号;ADC为低信号;ADC值为(0.55±0.14)×10~(-3) mm~2/s;病灶直径(8.62±9.27)mm。病灶部位:10例脑叶,7例基底节及侧脑室旁,2例小脑,2例苍白球,1例脑干。12例侧脑室前后角白质周围片状、云雾状长T_1、长T_2异常信号病灶;11例双侧基底节及侧脑室旁点状长T_1、长T_2异常信号为陈旧性腔隙性梗死;7例脑萎缩。13例MRA表现:8例(61.53%)动脉狭窄,5例(38.46%)动脉管腔僵硬。结论应用头颅MRI、MRA对急性CO中毒伴发急性脑梗死的早期临床诊断、病情程度及预后的评估有一定的实用价值。
Objective To evaluate the diagnostic value of MRI and MRA in patients with acute CO poisoning complicated by acute cerebral infarction. Methods A retrospective analysis of 15 cases of clinically diagnosed acute CO poisoning associated with acute cerebral infarction in patients with head MRI, MRA data. Results The lesions of acute cerebral infarction in 15 patients were as follows: MRI was punctate and patchy abnormal signal; DWI showed high signal; ADC was low signal; ADC value was (0.55 ± 0.14) × 10 -3 mm 2 / s; lesion diameter (8.62 ± 9.27) mm. Lesions: 10 cases of brain lobes, 7 cases of basal ganglia and lateral ventricle, 2 cases of cerebellum, 2 cases of globus pallidus, 1 case of brain stem. Twelve cases of lateral ventricle before and after the white matter around the white flaky, cloud-like long T_1, T 2 abnormal signal lesions; 11 cases of bilateral basal ganglia and lateral ventricle punctate long T_1, T_2 abnormal signal for the old lacunar infarction; 7 Cases of brain atrophy. Thirteen MRA manifestations showed arterial stenosis in 8 cases (61.53%) and rigid artery in 5 cases (38.46%). Conclusion The application of cranial MRI and MRA has some practical value in the early clinical diagnosis, severity of illness and prognosis of patients with acute CO poisoning complicated by acute cerebral infarction.