CAJ | 학술논문

目的：探讨早期脑梗死CT表现，寻找病变最早出现的部位、与临床表现及相关血流动力学改变的相关性。方法对我院2009-2013年度患者60例，在病发后0.5-6小时内CT检查，后经CT、MRI或DSA证实单侧大脑中动脉主干栓塞致大片脑梗死，但无合并颈内动脉及大脑前、后动脉栓塞患者，对首次CT影像学表现进行分析，并将其与脑动脉侧枝循环供血情况及临床表现进行了对比研究。结果60例急性脑梗死患者中57例表现出阳性征象，一侧大脑中动脉高密度征23例，基底节区密度减低55例，岛叶密度减低42例，局部脑皮质密度减低40例，局部脑组织肿胀36例。临床症状重度23例，中度22例，轻度15例。结论出现连片急性脑梗死是按M1、M2、M3、M4、M5段沿途分布，最早出现病变部位由近到远延伸，依次是：1大脑中动脉主干高密度征；2基底节区密度减低；3岛叶及颞下前叶密度减低；4大脑背外侧前部颞额顶叶交界部皮质区密度减低；5大脑背外侧后部枕叶及顶后叶皮质密度减低。临床症状的严重程度与早期CT表现病变部位及范围有相关性，P＜0.05，首次检出大脑中动脉高密度征及大脑所属各部位病灶越多，其临床症状越重，CT或MR复查脑梗死大片病变范围越大，即病人预后越差。
목적：탐토조기뇌경사CT표현，심조병변최조출현적부위、여림상표현급상관혈류동역학개변적상관성。방법대아원2009-2013년도환자60례，재병발후0.5-6소시내CT검사，후경CT、MRI혹DSA증실단측대뇌중동맥주간전새치대편뇌경사，단무합병경내동맥급대뇌전、후동맥전새환자，대수차CT영상학표현진행분석，병장기여뇌동맥측지순배공혈정황급림상표현진행료대비연구。결과60례급성뇌경사환자중57례표현출양성정상，일측대뇌중동맥고밀도정23례，기저절구밀도감저55례，도협밀도감저42례，국부뇌피질밀도감저40례，국부뇌조직종창36례。림상증상중도23례，중도22례，경도15례。결론출현련편급성뇌경사시안M1、M2、M3、M4、M5단연도분포，최조출현병변부위유근도원연신，의차시：1대뇌중동맥주간고밀도정；2기저절구밀도감저；3도협급섭하전협밀도감저；4대뇌배외측전부섭액정협교계부피질구밀도감저；5대뇌배외측후부침협급정후협피질밀도감저。림상증상적엄중정도여조기CT표현병변부위급범위유상관성，P＜0.05，수차검출대뇌중동맥고밀도정급대뇌소속각부위병조월다，기림상증상월중，CT혹MR복사뇌경사대편병변범위월대，즉병인예후월차。
Objective To investigate the CT evolution and the changes of hemodynamics of acute cerebral infarction caused by unilateral middle cerebral artery embolism.Methods Analyzed the CT performance of acute cerebral infarction and relation among the CT, clinical symptom and the cerebral artery perfusion. A total of 60 patients accepted CT scan 0.5-6 hours after the clinical symptom appeared. And the following CT, MRI or DSA scan showed that the artery embolism caused by cerebral infarction in the brain are unilateral, and all the patients with no internal carotid artery and anterior cerebral artery embolism.Results 60 cases of patients with acute cerebral infarction 57 cases showed positive findings, 23 cases of middle cerebral artery sign high density, density and basal ganglia decreased in 55 cases, the insular low density in 42 cases, local cerebral cortical density decreased in 40 cases, and local brain tissue swelling in 36 cases. The clinical symptoms of 23 cases were severe, 22 moderate cases, mild in 15 cases.Conclusion The distribution of acute cerebral infarction was relevant with the distribution of M1, M2, M3, M4, M5 segment. The earliest lesions from proximal to distal extension is in turn: 1 middle cerebral arterial high density sign; 2 basal ganglia lower density; 3 temporal anterior lobe insular under low density; 4 dorsal lateral front part of the brain the frontal-temporal parietal junction cortex decreased density of brain; 5 dorsal lateral posterior occipital and posterior parietal cortex decreased density. The severity of the Clinical symptoms has relation ship to the location and the range of the infarction on CT, P<0.05.