CAJ | 학술논문

目的应用神经影像检查,分析大脑中动脉闭塞性疾病(MCAOD)患者梗死类型分布和脑灌注异常. 方法对经CT血管造影(CTA)证实的116例MCAOD患者的CT平扫、CT灌注成像(CTP)和CTA的影像资料进行回顾性分析,确定其脑梗死类型分布和脑灌注改变. 结果 116例患者中,CTA共检出133条大脑中动脉(MCA)狭窄或闭塞,其中单侧者99例,双侧者17例.其中MCA闭塞25条,重度狭窄39条,中、轻度狭窄69条.CT或MRI显示腔隙性脑梗死(LIS)45例,各型分水岭脑梗死(CWSI)38例,流域性脑梗死26例,纹状体内囊梗死(SCI)10例,未检出梗死病灶14例.CTP显示MCA供血区内脑血流灌注异常96例,其中58例有MCA供血区的大范围血流灌注减低.未检出血流灌注异常者37例. 结论由于MCA狭窄的部位、程度和发病机制的不同以及侧支循环的建立,MCAOD可造成不同类型的脑梗死和血流灌注异常.
목적 응용신경영상검사,분석대뇌중동맥폐새성질병(MCAOD)환자경사류형분포화뇌관주이상. 방법 대경CT혈관조영(CTA)증실적116례MCAOD환자적CT평소、CT관주성상(CTP)화CTA적영상자료진행회고성분석,학정기뇌경사류형분포화뇌관주개변. 결과 116례환자중,CTA공검출133조대뇌중동맥(MCA)협착혹폐새,기중단측자99례,쌍측자17례.기중MCA폐새25조,중도협착39조,중、경도협착69조.CT혹MRI현시강극성뇌경사(LIS)45례,각형분수령뇌경사(CWSI)38례,류역성뇌경사26례,문상체내낭경사(SCI)10례,미검출경사병조14례.CTP현시MCA공혈구내뇌혈류관주이상96례,기중58례유MCA공혈구적대범위혈류관주감저.미검출혈류관주이상자37례. 결론 유우MCA협착적부위、정도화발병궤제적불동이급측지순배적건립,MCAOD가조성불동류형적뇌경사화혈류관주이상.
Objective To study the cerebral infarction subtypes and brain perfusion abnormalities in patients with middle cerebral artery occlusive disease (MCAOD) based on findings in neuroradiological imaging. Methods In 116 MCAOD cases confirmed by CT angiography (CTA), the data of plain CT scanning, CT perfusion imaging, and CTA were retrospectively analyzed to identify the cerebral infarction subtypes and brain perfusion abnormalities. Results In the 116 cases enrolled in this study, CTA detected 133 middle cerebral arteries (MCA) with stenotie or occlusive lesions, which involved unilateral MCA in 99 cases and bilateral MCA in 17 cases. Severe MCAOD were found in 64 cases (including 25 with MCA occlusion and 39 with severe MCA stenosis), and moderate and mild MCA stenosis in 69 cases. CT or magnetic resonance imaging (MRI) identified multiple lacunar infarctions in 45 cases, territorial infarctions in 26 cases, watershed infarctions of different types in 38 cases, striatocapsular infarctions in 10 cases and no infarction associated with the stenotic MCA in 14 cases. CT perfusion imaging showed hypoperfusion areas in 96 cases (72.2%), including 58 cases with perfusion abnormalities involving large areas in the territory supplied by the MCA; no perfusion abnormalities were found in 37 cases. Conclusion According to the severity and location of MCA stenosis, pathogenesis of stroke and the establishment of collateral circulation, MCAOD may cause different types of cerebral infarction and brain perfusion abnormalities.