CAJ | 학술논문

目的：探讨大脑中动脉严重狭窄或闭塞患者临床与影像学特征。方法回顾性分析35例大脑中动脉中重度狭窄或闭塞患者的临床资料，并对其临床表现、MRA影像学特征进行分析。结果临床表现：35例患者均表现为偏瘫，其中面部和上下肢同时受累16例(45.7％)，上下肢同时受累11例(31.4％)，面部及上肢受累3例(8.6％)，单纯面部受累2例(5.7％)，面部及下肢受累2例(5.7％)，单纯上肢受累1例(2.9％)。MRA影像学特征及脑梗死类型：29例(82.9％)患者表现为病变侧MCA中度以上狭窄，6例(17.1％)表现为MCA闭塞。30例(85.7％)表现为缺血性梗死灶，其中深部小梗死最为常见(53.3％)，其次为交界区梗死(26.7％)，皮层区域内脑梗死相对较少(20.0％)。结论偏瘫是大脑中动脉狭窄或闭塞患者常见的临床症状，主要表现为面部和上下肢同时受累；深部小梗死是影像学脑梗死常见的类型。
목적：탐토대뇌중동맥엄중협착혹폐새환자림상여영상학특정。방법회고성분석35례대뇌중동맥중중도협착혹폐새환자적림상자료，병대기림상표현、MRA영상학특정진행분석。결과 림상표현：35례환자균표현위편탄，기중면부화상하지동시수루16례(45.7％)，상하지동시수루11례(31.4％)，면부급상지수루3례(8.6％)，단순면부수루2례(5.7％)，면부급하지수루2례(5.7％)，단순상지수루1례(2.9％)。MRA영상학특정급뇌경사류형：29례(82.9％)환자표현위병변측MCA중도이상협착，6례(17.1％)표현위MCA폐새。30례(85.7％)표현위결혈성경사조，기중심부소경사최위상견(53.3％)，기차위교계구경사(26.7％)，피층구역내뇌경사상대교소(20.0％)。결론편탄시대뇌중동맥협착혹폐새환자상견적림상증상，주요표현위면부화상하지동시수루；심부소경사시영상학뇌경사상견적류형。
Objective To evaluate the clinical and imaging features and infarct pattern in patients with middle cerebral artery(MCA) stenosis and occlusion,to clarify its infarct pathogenesis. Methods 35 MCA moderate and severe stenosis or occlusion patients diagnosed by TCD were studied;the clinical and imaging features and infarct pattern were retrospectively analyzed. Results ( 1 ) Clinical features :The clinical manifestations of 35 patients was hemiplegia symptoms,in which 16 cases(45.7％ ) involved to the face,upper and lower limb,11 cases(31.4％ ) involved to the upper and lower limb,3 cases(8.6％ ) involved to the facial and upper limb,2 cases(5.7％ ) involved only to the facial,2 cases(5.7％ ) involved to the facial and upper limb,1 cases(2.9％ ) involved only to the upper limb. (2) MRA imaging characteristics and infarct pattern: 29 cases ( 82.9％ ) of patients with stenosis or occlusion showed moderate severe stenosis,6 cases( 17.1％ ) showed MCA occlusion. 30 cases( 85.7％ ) showed ischemic infarction,in which perforating artery infarction was the most common infarct pattern of middle cerebral artery stenosis or occlusive patients( 53.3％ ) ,followed by water-shed infarct ( 26. 7) ％, pial infarct was ielatively small (20. 0％ ). Conclusion The hemiplegia was the most common clinical symptoms in patients with MCA stenosis and occlusion, and mainly involves to the face,upper and lower limb;The perforating artery infarction was the most common infarct pattern,and its infarct mechanism was an artery-to-artery embolism or hemodynamic abnormalities.