SWI的临床应用课题.ppt

* * 海蛇头或蜘蛛样改变 * 左侧大脑半球大的静脉发育异常，常规GRE序列显示不清 * * 斯特奇-韦伯综合征（脑面血管瘤病）与发育异常导致的血管畸形有关 * * * 脑组织局限性炎性病变,退行性变及老化,使小动脉与毛细血管的通透性发生改变,促使血清中淀粉样物质沉积在脑组织中与血管壁上. 皮层和皮层下各阶段的多发斑点状皮层出血和脑室旁白质变性 * * * * * CT is considered the gold standard for stroke assessment, however it does not image all the mirco bleed, hematoma and hemorrhage complications. * 梗塞性出血的临床治疗更为棘手，一旦发现梗塞合并出血，临床常常考虑停止溶栓治疗，所以早期发现梗塞后出血对于临床更有意义。 * 增强扫描病灶强化不明显、边界不清，SWI显示病灶内的血管及出血点，提示病灶恶性程度可能偏高、同时相对清楚的勾勒出了肿瘤的边界。 * SWI显示病灶内和病灶边缘较丰富的血管组织、出血灶。 * * * * Diffuse axonal injury (DAI), an example of TPI, is caused by shearing stress in white matter, and results in hemorrhagic and non-hemorrhagic lesions. SWI, owing to its sensitivity to venous blood and the susceptibility of lesions, could prove to be advantageous for evaluating DAI. Due to this sensitivity, SWI provides additional and useful information that can help improve the detection, evaluation, and treatment of patients with DAI and other trauma related injuries. SWI imaging brings out multiple micro bleeds at the gray- white junction, which suggest diffuse axonal injury (DAI). Also, the evidence of a right frontal hematoma appears in the image using SWI processing. * * 评估疾病进展及治疗效果The arrows in these images point to mineralization along the motor cortex, revealing degenerative brain disease. * 铜代谢异常；壳核、苍白球铜沉积； * 血管源性病变 血管源性病变 MIP SWI vs. CT 左侧基底节区梗死 肿瘤性病变 肿瘤性病变 SWI可以显示肿瘤的边界、静脉、出血及钙化等 肿瘤性病变 High Resolution Tumor Imaging-SWI Flash 3D T1 post-Gad SWI No-Gad Surrounding venous vasculature and tumor internal hemorrhage. Also seen are (arrows) micro hemorrhages which are not seen in T1 weighted images. 肿瘤性病变 SWI T1 + contrast Hemorrhage into Glioma 肿瘤性病变 颅脑外伤性疾病 弥漫性轴索损伤DAI 颅脑外伤性疾病 弥漫性轴索损伤DAI 颅脑外伤性疾病 弥漫性轴索损伤DAI 颅脑外伤性疾病 GRE Image vs. SWI postprocessing 神经退行性疾病 神经退行性疾病 以脑内铁质沉积增多为特征 Alzheimer’s disease Parkinson’s disease 多发性硬化（MS） 神经退行性疾病 Alzheimer病 中央前回皮层、齿状核铁质含量增高 神经退行性疾病 SWI minIP vs. SWI phase image 中央前回皮层的矿物质沉积增多 神经退行性疾病 Parkinson’s disea