Kết quả ứng dụng chuỗi xung khuếch tán cộng hưởng từ trong chẩn đoán nhồi máu não

Abstract

Objective: To evaluate the application of the diffusion-weighted magnetic resonance imaging in the diagnosis of cerebral infarction. Subject and method: A retrospective, cross-sectional descriptive study was carried out on 61 patients with cerebral infarction who underwent a magnetic resonance imaging (MRI) of brain and cerebral vessels with diffusion weighted imaging sequences at Hanoi Medical University Hospital. Result: Mean age was 66.3 ± 10.7, the lowest was 43, the highest was 91-year-old. Male/female ratio was 1.8/1. The mean time from onset to MRI was 23.1 ± 22.9 hours. MRI scan between 6-24 hours accounted for 45.9%. Supratentorial infarctus was 88.5%. The mean volume of cerebral infarction was 21.2 ± 40.2cm³. The detection rate of infarctus volume ≤ 1cm³ was 85.7%, over 1cm³ was 100%. The high-intensity signal rate on DWI before 6 hours, from 6-24 hours, after 24 hours and overall rate were 90.9%, 96.4%, 100% and 96.7%, respectively. Before 6 hours, the detection rate of cerebral infarction on T1WI and T2WI were 36.4% and 39.3%, respectively. The detection rate of cerebral infarction on FLAIR imaging before 6 hours, from 6-24 hours and after 24 hours were 54.5%, 89.3% and 81.2%, respectively. The vascular abnormalites on TOF was 52.5%. The DWI sensitivity on cerebral infarction detection in overall, before 6 hours and after 24 hours were 96.7%, 90.9% and 100%, respectively. Conclusion: DWI sequence had the highest value in the cerebral infarctus diagnosis, compared to other MRI sequences, especially in the hyper-acute stroke (before 6 hours). Therefore, we could recommend that the patient with acute stroke should be underwent early DWI.