回溯研究-探討腦部無施打顯影劑電腦斷層和軸切擴散加權成像磁振造影與中風的相關性

本研究的目的，對於懷疑急性中風的受檢者，分別以腦部磁振造影的擴散加權成像序列及電腦斷層檢查，判斷急性中風的可能性，以臨床診斷資訊比較兩者的診斷正確性。藉此研究評估電腦斷層或擴散加權成像磁振造影能夠早期診斷急性缺血性中風，以達到早期診斷，早期治療的目的。本研究是回溯性研究，收集2013.01.01-2017.12.31無施打對比劑的腦部電腦斷層且1天以內也有執行無施打對比劑腦部磁振造影受檢者的影像，和臨床診斷資訊，然後從其中隨機抽選100人。電腦斷層和磁振造影報告結果和擴散加權成像、表觀擴散係數圖影像資料，由2名影像醫學科放射師判斷是否有異常。判斷結果與受檢者的臨床診斷資訊，是否急性中風的診斷有所相符合，以卡方-獨立性檢定分析評估其關聯性。電腦斷層報告卡方值0.01 <.027<0.05(有充分證據表明備選假設是正確的。測試很重要)。腦部磁振造影擴散加權成像的影像是否有信號強度異常的增強，磁振造影的報告卡方值均<0.01(有大量證據表明替代假設是正確的。該測試非常重要。)，可以證明磁振造影的影像相對於電腦斷層於診斷急性中風有非常大的診斷價值。以腦部磁振造影中的擴散加權成像影像診斷急性中風，靈敏度高於電腦斷層掃描。針對高度懷疑之受檢者，若能使用擴散加權成像影像早期診斷急性中風，則能增加早期血栓溶解劑介入機會，以改善預後。

關鍵字

磁振造影；電腦斷層；擴散加權成像；表觀擴散係數圖；急性中風

並列摘要

The purpose of this study was to determine the possibility of acute stroke with MRI DWI and CT examination , and to compare the diagnostic accuracy with clinical diagnostic information. This study evaluated CT or DWI MRI for early diagnosis of acute ischemic stroke for early diagnosis and early treatment. This study is a retrospective study, collecting images and clinical diagnosis information of Brain CT without contrast agent and within 1 day also performing images of Brain MRI without contrast agent at 2013.01.01-2017.12.31,and then randomly selected 100 people from it. The CT and MRI report results ,and DWI and ADC Map image data were judged by two radiographers. The judgment result compared to the clinical diagnosis information of the subject, whether the diagnosis of acute stroke is consistent, and the correlation is evaluated by the chi-square-independence test analysis. CT report Pearson value of 0.01 <.027<0.05 (there is sufficient evidence that the alternative hypothesis is correct. The test is important). Brain MRI DWI images have an increase in signal intensity anomalies,and Brain MRI reports Pearson values <0.01 (there is a lot of evidence that the substitution hypothesis is correct. This test is very important.), it can be proved that the MRI image is relative CT has a very large value in the diagnosis of acute stroke. To diagnose acute stroke with MRI DWI images, the sensitivity is higher than that of CT. For highly suspected subjects, early diagnosis of acute stroke using DWI can increase the chance of early thrombolytic intervention to improve outcomes.

並列關鍵字

MRI ； CT ； DWI ； ADC Map ； acute stroke

參考文獻

1. https://www.csie.ntu.edu.tw/~b95041/biomedical/11_16_MR_Simple.pdf第15 章核磁共振與磁振造影 (Nuclear Magnetic Resonance and Magnetic Resonance Imaging)台灣大學電機系核磁共振影像光譜實驗室陳志宏教授台灣大學醫學院附設醫院影像醫學部張允中醫師台灣大學電機系核磁共振影像光譜實驗室謝昭賢博士等編著。

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2. https://zh.wikipedia.org/wiki/中風。

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3. RadioGraphics 2012; 32:1285–1297, Sequence-specific MR Imaging Findings That Are Useful in Dating Ischemic Stroke

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Laura M. Allen, MD • Anton N. Hasso, MD • Jason Handwerker, MD•Hamed Farid, MD.。

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4. Topics in Magnetic Resonance Imaging Volume 26, Number 2, April 2017, Diffusion and Perfusion MR Imaging in Acute Stroke: Clinical Utility and Potential Limitations for Treatment Selection

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回溯研究-探討腦部無施打顯影劑電腦斷層和軸切擴散加權成像磁振造影與中風的相關性

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