1、The First Affiliated Hospital Zhejiang Chinese Medical University SWISWI的原理及临床应用的原理及临床应用2016-12-02The First Affiliated Hospital Zhejiang Chinese Medical University SWI成像原理简介 SWI的临床应用The First Affiliated Hospital Zhejiang Chinese Medical University SWI成像原理 SWI是一种利用不同组织间的磁敏感性差异而成像的技术，对小静脉、微出血和铁沉积更敏感。
2、成像基础：组织间磁敏感度差异The First Affiliated Hospital Zhejiang Chinese Medical University SWI成像原理 以T2*加权梯度回波序列作为序列基础，分别采集强度数据和相位数据的方式，并在此基础上进行数据的后处理，可将处理后的相位信息叠加到强度信息上，更加强调组织间的磁敏感性差异，形成最终的SWI图像The First Affiliated Hospital Zhejiang Chinese Medical University 与SWI相关的组织磁敏感性特点 血红蛋白及其降解产物 氧合血红蛋白：Fe2+与氧结合，没有不成对的电子
3、，为反磁性 去氧血红蛋白：带有4个不成对的电子，顺磁性 正铁血红蛋白：血红蛋白进一步氧化为，含5个不成对电子，具有较强顺磁性，但磁敏感性较弱，主要缩短T1弛豫时间 含铁血黄素：高度顺磁性，磁敏感性较强The First Affiliated Hospital Zhejiang Chinese Medical University 非血红蛋白铁及钙化的磁敏感性 非血红蛋白铁在体内以铁蛋白常见，为高度顺磁性。正常人随年龄增加，铁在脑内沉积增加，但在某些神经变性疾病中，如帕金森病、阿尔茨海默病等，铁异常沉积 钙化：在脑内的结合状态是弱反磁性，但大多数情况下可以产生局部磁场，导致信号去相位，造成T2*
4、缩短，信号减低The First Affiliated Hospital Zhejiang Chinese Medical University SWI的影像对比：用于小静脉显像The First Affiliated Hospital Zhejiang Chinese Medical University 无论顺磁性物质还是反磁性物质，只要能改变局部磁场，导致空间相位的改变，就能产生信号的去相位，造成T2*时间缩短。去相位的结果不取决于物质是顺磁性还是反磁性，而取决于物质在一个体素内能多大程度地改变磁场The First Affiliated Hospital Zhejiang Chines
5、e Medical University The First Affiliated Hospital Zhejiang Chinese Medical University SWI的临床应用 血管源性病变 肿瘤性病变 颅脑外伤 神经退行性疾病 其他The First Affiliated Hospital Zhejiang Chinese Medical University 血管源性病变 血管源性病变 海绵状血管瘤 动静脉畸形 毛细血管扩张症 淀粉样脑血管病（CAA） 脑梗死及出血The First Affiliated Hospital Zhejiang Chinese Medical U
6、niversity 左侧小脑海绵状血管瘤合并出血左侧小脑海绵状血管瘤合并出血The First Affiliated Hospital Zhejiang Chinese Medical University 多发出血的海绵状血管瘤多发出血的海绵状血管瘤The First Affiliated Hospital Zhejiang Chinese Medical University 血管畸形血管畸形The First Affiliated Hospital Zhejiang Chinese Medical University 右额叶深部血管发育畸形右额叶深部血管发育畸形The First Af
7、filiated Hospital Zhejiang Chinese Medical University 右枕叶静脉畸形右枕叶静脉畸形The First Affiliated Hospital Zhejiang Chinese Medical University 左侧顶枕叶动静脉畸形左侧顶枕叶动静脉畸形The First Affiliated Hospital Zhejiang Chinese Medical University 左侧大脑半球静脉发育畸形左侧大脑半球静脉发育畸形The First Affiliated Hospital Zhejiang Chinese Medical U
8、niversity 放射性毛细血管扩张症放射性毛细血管扩张症The First Affiliated Hospital Zhejiang Chinese Medical University 淀粉样脑血管病淀粉样脑血管病The First Affiliated Hospital Zhejiang Chinese Medical University 淀粉样脑血管病淀粉样脑血管病CAAThe First Affiliated Hospital Zhejiang Chinese Medical University MIP SWI CT左侧基底节区梗死左侧基底节区梗死 合并微小出血灶合并微小出血灶
9、The First Affiliated Hospital Zhejiang Chinese Medical University 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The First Affiliated Hospital Zhejiang Chinese Medical University T1-CEFlairSWIThe First Affiliated Hospital Zhejiang Chinese Medical University SWIT1-CE胶质瘤合并出血胶质瘤合并出血The First Affiliated Hospital Zhe
10、jiang Chinese Medical University 右侧脑室肿瘤静脉分布和出血灶右侧脑室肿瘤静脉分布和出血灶The First Affiliated Hospital Zhejiang Chinese Medical University 颅脑外伤性疾病 颅脑外伤性疾病 弥漫性轴索损伤（DAI） 外伤性脑出血及梗死The First Affiliated Hospital Zhejiang Chinese Medical University 颅脑外伤性疾病弥漫性轴索损伤DAIThe First Affiliated Hospital Zhejiang Chinese Medic
11、al University 弥漫性轴索损伤DAIThe First Affiliated Hospital Zhejiang Chinese Medical University 弥漫性轴索损伤弥漫性轴索损伤DAIThe First Affiliated Hospital Zhejiang Chinese Medical University 外伤后右侧额叶微小出血灶外伤后右侧额叶微小出血灶The First Affiliated Hospital Zhejiang Chinese Medical University 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Alzheimers
12、 diseaseParkinsons disease钙质沉积The First Affiliated Hospital Zhejiang Chinese Medical University Alzheimers disease齿状核铁质含量增高齿状核铁质含量增高The First Affiliated Hospital Zhejiang Chinese Medical University Parkinsons disease黒质区燕尾征消失黒质区燕尾征消失The First Affiliated Hospital Zhejiang Chinese Medical University Th
13、e First Affiliated Hospital Zhejiang Chinese Medical University 钙化性疾病双侧苍白球钙化双侧苍白球钙化The First Affiliated Hospital Zhejiang Chinese Medical University 钙化性疾病少突胶质细胞瘤钙化斑少突胶质细胞瘤钙化斑The First Affiliated Hospital Zhejiang Chinese Medical University 其他疾病肝豆状核变性肝豆状核变性The First Affiliated Hospital Zhejiang Chinese Medical University The First Affiliated Hospital Zhejiang Chinese Medical University Thank You !
