Shulou(Shulou.com)06/02 Report--

In this issue, the editor will bring you about the performance of cerebrovascular diseases on MRI images. the article is rich in content and analyzes and narrates it from a professional point of view. I hope you can get something after reading this article.

Last week I shared an article about the performance of cerebrovascular diseases on MRI, and some friends put forward valuable suggestions, so I share today's article in an illustrated way on the basis of the previous article.

Hypertensive intracerebral hemorrhage

(1) Clinical manifestations and pathological features

When the blood pressure rises suddenly, the blood spills out of the blood vessel after the rupture of the internal cerebral artery, forming a hematoma in the brain. Most of the bleeding occurred in the basal ganglia, thalamus, cerebellopontine hemisphere and cerebellum. Elderly patients with hypertension are more common, with high morbidity and mortality.

(2) MRI performance

Cerebral hemorrhage forms space-occupying in the brain parenchyma to a certain extent, and the larger hematoma is often accompanied by peripheral edema, and the space-occupying effect is more obvious. The signal of hematoma varies from stage to stage.

Hyperacute cerebral infarction and acute cerebral infarction

(1) Clinical manifestations and pathological features

Cerebral infarction is an ischemic cerebrovascular disease in the corresponding blood supply area of the brain caused by cerebral arterial occlusion. MRI can show early lesions to a greater extent than CT. For small lesions and infratentorial infarcts, especially brainstem lesions, MRI is superior to CT.

(2) MRI performance

Within 6 hours of acute cerebral infarction, cytotoxic edema occurs due to ischemia and hypoxia of brain cells in the infarcted area. In this period, the signal changes of T1WI and T2WI are not obvious, so it is difficult to diagnose. At this time, using MR diffusion imaging, we can find the location and size of the infarction focus early.

Angiogenic edema occurred within one day to one week, including cell death, demyelination, destruction of blood-brain barrier and further aggravation of edema. The relaxation time of T1 and T2 was prolonged, low signal intensity on T1WI and high signal intensity on T2WI. The infarcted area is consistent with the blood supply area of the occlusive artery, which is a wedge-shaped or fan-shaped bottom facing outward long T1 and T2 signal, and the cortex and medulla are involved at the same time.

In the later stage of cerebral infarction, small lesions can not be displayed in time, and the main manifestation is focal brain atrophy. The large lesions formed malacia with brain atrophy, and the T1WI and T2WI of the malacia were significantly prolonged.

IV. Cerebral aneurysms

(1) Clinical manifestations and pathological features

A cerebral aneurysm is a focal abnormal cystic enlargement that occurs in the internal cerebral artery. It usually occurs in the circle of cerebral artery and its adjacent branches.

(2) MRI performance

Due to the different blood flow velocity in the larger aneurysm, the part with fast blood flow showed "flow void effect". The part with slow blood flow showed low signal on T1WI and high signal on T2WI.

VI. Cerebral microvascular disease

(1) Clinical manifestations and pathological features

Cerebral small vessel (cerebral small vessel disease,CSVD) refers to the disease caused by small blood vessel lesions in the brain whose internal diameter is less than 0.4mm.

(2) MRI performance

CSVD-related MRI findings included multiple lacunar infarction, leukoaraiosis, microhemorrhage and enlarged perivascular space. Taking multiple lacunar infarction as an example, MRI images showed small round, long T1 and long T2 signals in bilateral basal ganglia or thalamus, with a diameter of about 10-15cm. MRI is easier to find the luminal infarcts of brainstem and cerebellum than CT.

The above is the performance of cerebrovascular diseases shared by the editor on MRI images. If you happen to have similar doubts, you might as well refer to the above analysis to understand. If you want to know more about it, you are welcome to follow the industry information channel.

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