动脉瘤性蛛网膜下腔出血患者磁共振弥散加权成像异常的临床研究

Clinical Study of Abnormal Magnetic Resonance Diffusion Weighted Imaging in Patients with Aneurysmal Subarachnoid Hemorrhage

摘要: 目的：分析动脉瘤性蛛网膜下腔出血(Aneurysmal Subarachnoid Hemorrhage, aSAH)患者磁共振弥散加权成像(Diffusion Weighted Imaging, DWI)影像信息，探索其信号异常的相关因素以及与迟发性脑缺血(Delayed Cerebral Ischemia, DCI)的相关性。方法：回顾性分析2020年8月至2023年6月于包头市中心医院神经内科诊断为aSAH的患者，所有患者入院后均行头颅磁共振检查，包括T1、T2序列及DWI序列，根据DWI序列是否存在高信号分为DWI正常组和DWI异常组，采集两组患者临床资料，进行统计分析。结果：1) 共入组42例患者，DWI异常组22例，DWI正常组20例；2) 两组在Fisher分级、Hunt-Hess分级及行是否行脑脊液置换上有显著差异(P < 0.05)；3) DWI异常与DCI的发生有显著差异(P < 0.05)。结论：Fisher分级、Hunt-Hess分级是aSAH患者DWI异常发生的危险因素，DWI异常是DCI的危险因素。

Abstract: Objective: To analyze the diffusion weighted imaging (DWI) image information from patients with aneurysmal subarachnoid hemorrhage (aSAH), to explore the correlation factors of signal abnormality and its correlation with delayed cerebral ischemia (DCI). Methods: Patients diagnosed with aSAH in the Department of Neurology of Baotou Central Hospital from August 2020 to June 2023 were retrospectively analyzed. All patients underwent head magnetic resonance examination after admission, including T1, T2 sequence and DWI sequence. According to the presence of high signal in DWI sequence, they were divided into normal DWI group and abnormal DWI group. The clinical data of the two groups were collected and analyzed statistically. Results: 1) A total of 42 patients were enrolled, including 22 patients with abnormal DWI and 20 patients with normal DWI. 2) There were significant differences in Fisher grading, Hunt-Hess grading and cerebrospinal fluid replacement between the two groups (P < 0.05); 3) There was a significant difference between the abnormality of DWI and the occurrence of DCI (P < 0.05). Conclusion: Fisher grading and Hunt-Hess grading are risk factors for DWI abnormalities in aSAH patients, and DWI abnormalities are risk factors for DCI.