查詢結果分析
相關文獻
- 3小時內腦梗塞於磁振造影擴散加權影像b值參數陷阱--病例報告
- 擴散影像在腦缺血及梗塞診斷上的應用價值
- 以擴散加權影像法(DWI)探討幾何形狀與溫度對擴散係數的影響
- Weber's Syndrome Associated with Supranuclear Vertical and Horizontal Gaze Palsy: A Case Report
- Neuroimaging of Pediatric Cerebral Infarctions
- 以磁振造影觀察腦幹之瓦勒氏退化
- 3T磁振造影使用不同b值於腦梗塞擴散加權影像上的分析
- Posterior Reversible Encephalopathy Syndrome: Magnetic Resonance Imaging and Diffusion-Weighted Imaging in 12 Cases
- 超順磁性氧化鐵造影劑於肝臟擴散加權影像的應用
- Assessment with Magnetic Resonance Imaging and Spectroscopy in Lhermitte-Duclos Disease
頁籤選單縮合
題名 | 3小時內腦梗塞於磁振造影擴散加權影像b值參數陷阱--病例報告=The Trap of b-values in DWI on MRI for Cerebral Infarction within 3 Hours-Case Report |
---|---|
作者姓名(中文) | 王士崇; 陳文昌; 陳志峰; 林秋湧; 吳萬福; 廖漢弘; | 書刊名 | 中華放射線技術學雜誌 |
卷期 | 37:2 2013.06[民102.06] |
頁次 | 頁107-112 |
分類號 | 414.93 |
關鍵詞 | 磁振造影; 擴散加權影像; b值; 腦梗塞; Magnetic resonance imaging; MRI; Diffusion-weighted images; DWI; b-value; Cerebral infarction; |
語文 | 中文(Chinese) |
中文摘要 | 近年來國內外有許多針對腦梗塞缺血性腦中風病患MRI DWI的研究,並提出DWI「最佳化的b值參數」設定建議,但在「最佳化的b值參數」設定時MRI掃描擴散加權影像所呈現的結果是100%正確嗎?本院首次發現一病例,急診診斷疑似急性3小時內腦梗塞中風,在接受3T MRI掃描T1、T2、FLAIR、TOF MRA及DWI和ADC map影像中,檢查結果全部影像皆無腦梗塞發現,但現場臨床放射師根據臨床經驗及病理學知識,判斷DWI影像結果與病患實際症狀不符,合理懷疑MRI掃描參數不佳,並且馬上將DWI參數中的b值更改,由原本1300 s/mm^2提升至2000 s/mm^2,結果發現明顯的腦梗塞病灶於左側頂葉皮質處,確定為3小時內發生的急性腦梗塞中風,隨即讓病患回急診室進行rtPA治療。如果當時放射師臨床經驗及病學理知識不足,無法做出正確臨場反應,將會錯過腦梗塞中風黃金3小時的最佳治療時機,對病患而言將會造成莫大的嚴重後果。由此案例啟示,放射師應具有如何靈活操作檢查機器,及應用檢查參數與活用能力外,臨床病理、病患症狀等知識,實為臨床放射師須注重與學習之課題。 |
英文摘要 | There are a lot of researches regarding to patients with cerebral infarction cerebral ischemic stroke domestically and internationally in present years indicated that ”b-value optimization” in DWI should be set; however, does the result of DWI from MRI scanner be 100% correct when it is in optimized b-value? In one of the cases of our hospital, a patient under emergency diagnosis suspected that the patient received acute cerebral infarction stroke within 3 hours. After receiving the T1, T2, FLAIR, TOF MRA, DWI and ADC map from 3T MRI scanner, none of the images showed the result of cerebral infarction. Clinical radiologists on site decide that the image from DWI is not match the actual symptoms of patient based on clinical pathology experiences and theoretical knowledge. It is reasonable to doubt that the parameters of MRI scanner are inaccurate, therefore, parameters of b-value in DWI has been modified from 1300 s/mm^2 to 2000 s/mm^2 right away then lesions in the left parietal cortex of cerebral infarction are significantly shown on images. Patient received acute cerebral infarction stroke within 3 hours is confirmed. rtPA therapy has been treated on patient immediately back to the emergency room. If the clinical pathology experiences and theoretical knowledge of the on site clinical radiologist are insufficient and cannot provide immediately accurate diagnosis, the patient will miss the best treatment chance, which is the golden 3 hours for cerebral ischemic stroke patients. It might lead the patient to a very serious consequence. Therefore, from the experience of this case, radiologists not only need to know how to operate and examine the machine, which examining parameters and understanding the application of skills, but also need to know the knowledge of clinical pathology and patient symptoms. Those things in above are the topic that clinical radiologist should learn and focus on in the future. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。