神经损伤与功能重建
神經損傷與功能重建
신경손상여공능중건
NEURAL INJURY AND FUNCTIONAL RECONSTRUCTION
2014年
3期
218-221
,共4页
脑分水岭梗死%磁共振成像%磁共振血管造影%发病机制
腦分水嶺梗死%磁共振成像%磁共振血管造影%髮病機製
뇌분수령경사%자공진성상%자공진혈관조영%발병궤제
cerebral watershed infarction%magnetic resonance imaging%magnetic resonance angiography%mechanism
目的：探讨脑分水岭梗死（CWI）不同病变模式的 MRI、MRA 特点及其发病机制。方法：回顾性分析85例 CWI 患者，将梗死模式分为单纯性 CWI、混合性 CWI 和多发性 CWI。比较不同模式的 CWI 中大脑中动脉（MCA）、颈内动脉（ICA）病变情况。结果：85例 CWI 患者中，单纯性后分水岭梗死（PWI）6例，单纯性内分水岭梗死（IWI）11例，混合性前分水岭梗死（AWI）4例，混合性 PWI 9例，混合性 IWI 36例，多发性 CWI 19例。MCA 重度狭窄率明显高于 ICA 重度狭窄率（=0.00）。单纯性 IWI、混合性 IWI 和多发性 CWI MCA 重度狭窄率明显高于 ICA 重度狭窄率（＜0.01）。单纯性 IWI、混合性 AWI、混合性 IWI、多发性 CWI 的 MCA重度狭窄率均明显高于单纯性 PWI 和混合性 PWI（＜0.05）。结论：MCA 重度狭窄较 ICA 重度狭窄更易导致 CWI，尤其是导致 IWI、混合性 IWI 和多发性 CWI；MCA 重度狭窄对于前循环（颈内动脉系统）供血区的CWI 影响较大；MCA 重度狭窄引起狭窄远端的血流动力学障碍和微栓子清除能力下降，可能是导致 CWI以及 CWI 合并皮质区梗死（PI）和/或穿支动脉梗死（PAI）的机制之一。
目的：探討腦分水嶺梗死（CWI）不同病變模式的 MRI、MRA 特點及其髮病機製。方法：迴顧性分析85例 CWI 患者，將梗死模式分為單純性 CWI、混閤性 CWI 和多髮性 CWI。比較不同模式的 CWI 中大腦中動脈（MCA）、頸內動脈（ICA）病變情況。結果：85例 CWI 患者中，單純性後分水嶺梗死（PWI）6例，單純性內分水嶺梗死（IWI）11例，混閤性前分水嶺梗死（AWI）4例，混閤性 PWI 9例，混閤性 IWI 36例，多髮性 CWI 19例。MCA 重度狹窄率明顯高于 ICA 重度狹窄率（=0.00）。單純性 IWI、混閤性 IWI 和多髮性 CWI MCA 重度狹窄率明顯高于 ICA 重度狹窄率（＜0.01）。單純性 IWI、混閤性 AWI、混閤性 IWI、多髮性 CWI 的 MCA重度狹窄率均明顯高于單純性 PWI 和混閤性 PWI（＜0.05）。結論：MCA 重度狹窄較 ICA 重度狹窄更易導緻 CWI，尤其是導緻 IWI、混閤性 IWI 和多髮性 CWI；MCA 重度狹窄對于前循環（頸內動脈繫統）供血區的CWI 影響較大；MCA 重度狹窄引起狹窄遠耑的血流動力學障礙和微栓子清除能力下降，可能是導緻 CWI以及 CWI 閤併皮質區梗死（PI）和/或穿支動脈梗死（PAI）的機製之一。
목적：탐토뇌분수령경사（CWI）불동병변모식적 MRI、MRA 특점급기발병궤제。방법：회고성분석85례 CWI 환자，장경사모식분위단순성 CWI、혼합성 CWI 화다발성 CWI。비교불동모식적 CWI 중대뇌중동맥（MCA）、경내동맥（ICA）병변정황。결과：85례 CWI 환자중，단순성후분수령경사（PWI）6례，단순성내분수령경사（IWI）11례，혼합성전분수령경사（AWI）4례，혼합성 PWI 9례，혼합성 IWI 36례，다발성 CWI 19례。MCA 중도협착솔명현고우 ICA 중도협착솔（=0.00）。단순성 IWI、혼합성 IWI 화다발성 CWI MCA 중도협착솔명현고우 ICA 중도협착솔（＜0.01）。단순성 IWI、혼합성 AWI、혼합성 IWI、다발성 CWI 적 MCA중도협착솔균명현고우단순성 PWI 화혼합성 PWI（＜0.05）。결론：MCA 중도협착교 ICA 중도협착경역도치 CWI，우기시도치 IWI、혼합성 IWI 화다발성 CWI；MCA 중도협착대우전순배（경내동맥계통）공혈구적CWI 영향교대；MCA 중도협착인기협착원단적혈류동역학장애화미전자청제능력하강，가능시도치 CWI이급 CWI 합병피질구경사（PI）화/혹천지동맥경사（PAI）적궤제지일。
ObjectiveTo investigate the features of MRI and MRA in detecting different cerebral watershed in-farction (CWI) patterns. Methods: Eighty-five CWI patients were retrospectively divided into three types including simple CWI, mixed CWI and multiple CWI. The middle cerebral artery (MCA) and internal carotid artery (ICA) stenosis were evaluated in different CWI patterns. Results: There were 6 patients with simple posterior watershed infarction (PWI), 11 patients with simple internal watershed infarction (IWI), 4 patients with mixed anterior water-shed infarction (AWI), 19 patients with mixed PWI, 36 patients with mixed IWI and 19 patients with multiple CWI. Of the 85 patients, the ratio of severe stenosis of MCA was significantly higher than that of ICA ( =0.00). The ratio of severe stenosis of MCA was significantly higher than that of ICA in patients with simple IWI, mixed IWI and multiple CWI ( <0.01). The ratio of severe stenosis of MCA in patients with simple IWI, mixed AWI, mixed IWI and multiple CWI was significantly higher than that in the patients with simple PWI and mixed PWI ( <0.05). Conclusion: Severe stenosis of MCA is more likely to lead CWI than severe stenosis of ICA, especially in patients with IWI, mixed IWI and multiple CWI. Severe stenosis of MAC has a greater effect on CWI of anteri-or circulation (ICA system). Hemodynamic abnormality of the far side in patients with severe stenosis of MCA and the declined ability to eliminate micro-embolus may be of important mechanism.
