医学影像诊断学06脑血管病及颅内感染-文档资料.ppt
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1、脑血管病 HEMATOMA IN CT 血肿的CT表现,Inatially, high attenuation. higher attenuation than brain but less than bone (35-80 Hu). Over several days to weeks, gradual decrease in attenuation. Hypodensity to cystic cavity.,ACUTE HEMATOMA急性血肿 mild edema轻度水肿,SUBACUTE HEMATOMA 亚急性血肿,CHRONIC HEMATOMA慢性血肿,HEMATOMA IN
2、MRI,Acute (deoxyhemoglobin)急性期(脱氧血红蛋白 ) T1WI: Isointensity to mild hypointense 等到低信号 T2WI: Very high hypointense高信号 Early subacute(intracellular methemoglobin) 亚急性早期(细胞内高铁血红蛋白) TIWI: Increasing hyper-intensity T2WI: Hypo-intensity initially, changing to isointense,HEMATOMA IN MRI,Late subacute (Extr
3、acellular methemoglobin) 亚急性晚期 (细胞外高铁血红蛋白) T1WI: Hyper-intensity T1WI高信号 T2WI: Hyper-intensity centrally T2WI中心高信号 Chronic (Hemosiderin-laden macrophages remain) 慢性期 (含铁血黄素) A thin, hypointense rim appears TIWI: Hypo-intensity decreases over time T2WI: Rim of hypo-intensity increases, central hyperi
4、ntensity decrease, leaving only a low signal intensity scar,ACUTE HEMOTOMA :DEOXYHEMOGLOBIN,ACUTE HEMATOMA,SUBACUTE HEMOTOMA,CHRONIC HEMATOMA HEMOSIDERIN 慢性期(含铁血黄素),CEREBRAL INFARCTION 脑梗塞,The most common etiology of cerebral ischemia or infarction in the adult is occlusion of an artery resulting fr
5、om either thrombus formation or embolism, with atherosclerosis the most common underlying cause在成人,脑缺血或脑梗塞最常见病因是动脉闭塞,通常是血栓或动脉粥样硬化。 Carotid artery disease is especially common颈动脉疾病尤其常见。,CEREBRAL INFARCTION,ISCHEMIC INFARCTION缺血梗死 HEMORRHAGIC INFARCTION 出血性梗死形成 LACUNAR INFARCTION腔隙梗塞,Imaging appearanc
6、e,CT is often normal in the first few hours of infarction or ischemia, sometimes for up to 24 hours. 在梗死或缺血的最初几个小时,CT上通常表现为正常,有时甚至至24小时。 Subtle effacement of sulci may be an important early clue to infarction . 脑沟的细微消失可能是梗死的重要征象。,Imaging appearance,Some of the very earliest signs of MCA or internal
7、carotid artery infarction on CT . A. Loss of the insular strip of gray matter (loss of gray-white matter distinction) B. Low attenuation in the ipsilateral caudate head if the perforating arteries are also affected C. A high attenuation MCA, representing clot within the artery,Imaging appearance,Wit
8、h time, there is increasingly well-defined low attenuation in an area of infarction because of cytotoxic and vasogenic edema. Mass effect 占位效应 Thrombotic infarctions often involve a large vascular distribution, embolic infarctions usually involve only a portion of a major arterial territory. The typ
9、ical vascular distribution, often wedge-shaped and extending to the cortex.,Imaging appearance,MRI is more sensitive than CT for early changes of infarction, but in the first few hours after vascular occlusion, MRI also may appear normal. DWI, PWI may provide earlier evidence of infarction.对梗死的早期变化M
10、RI较CT敏感,但是在血管闭塞最初的几个小时,MRI也可是正常的。DWI,PWI能提供更早的梗死证据。 T1WI - low signal intensity低信号强度 T2WI - high signal intensity高信号强度 FLAIR - high signal intensity高信号强度,Loss of the insular strip of gray matter,Subtle effacement of sulci脑沟的微小消失,ACUTE INFARCTION LOW DESITY and MASS EFFECT低密度和占位效应,SUBACUTE INFARCTION
11、 LOW DENSUTY AND GYRIFORM ENHANCEMENT,CHRONIC INFARCTION LOW DENSUTY and ATROPHY,ACUTE INFARCTION LONG T1、 LONG T2 and MASS EFFECT,T1WI T2WI,Flow-void effect 流空效应,CHRONIC INFARCTION,GYRIFORM ENHANCEMEMT,HEMORRHAGIC INFARCTION 出血性梗死形成,LACUNAR INFACTION腔隙性梗死,hyperacute infarction 梗死的超急性期,Acute infarct
12、ion shows decreased diffusion, chronic infarction showing increased diffusion.,Clinical DWI can identify acute ischemic lesions that are not apparent on T2-Weighted MR images. DWI能分辨出无法在T2上显示的急性缺血部分,INTRACRANIAL INFECTION 颅内感染,The key diagnostic evidence in suspected meningitis comes from cerebrospi
13、nal fluid analysis and culture, imaging has an adjunctive role only.脑膜炎的主要诊断依据是脑脊液分析和培养,图像仅仅是从属地位。 Imaging may detect processes such as abscess and encephalitis, may localized focal conditions, and may help demonstrate the progress or resolution of infection图像可以显示脓肿和脑炎的征象,可帮助确定炎症的进展或消退。,INTRACRANIAL
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