国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2014年
2期
93-98
,共6页
椎底动脉供血不足%脑梗死%磁共振成像%脑血管造影术%体层摄影术,X线计算机
椎底動脈供血不足%腦梗死%磁共振成像%腦血管造影術%體層攝影術,X線計算機
추저동맥공혈불족%뇌경사%자공진성상%뇌혈관조영술%체층섭영술,X선계산궤
Vertebrobasilar Insufficiency%Brain Infarction%Magnetic Resonance Imaging%Cerebral Angiography%Tomography,X-Ray Computed
目的 探讨后循环梗死患者MRI所示的病变分布与CT血管造影(computerized tomography angiography,CTA)表现之间的联系.方法 纳入急性后循环梗死患者,依据MRI检查结果将梗死灶部位分为近段梗死、中段梗死和远段梗死.所有患者均行头颈部CTA检查.分析后循环梗死灶分布与椎基底动脉系统病变部位之间的联系.结果 共纳入急性后循环梗死患者203例,主要临床症状和体征包括单侧肢体无力(77例,37.93％)、头晕(129例,63.55％)、构音障碍(31例,15.27％)、恶心和呕吐(61例,30.05％)、头痛(79例,38.92％)、步态异常(50例,24.63％)、眼球震颤(34例,16.75％)和共济失调(21例,10.34％).近段梗死35例(17.24％):延髓梗死28例(13.79％),小脑后下部梗死7例(3.45％);中段梗死95例(46.79％):脑桥梗死80例(39.4％),小脑前下梗死15例(7.39％);远段梗死73例(35.96％):中脑梗死6例(2.96％),小脑上梗死16例(7.88％),丘脑梗死34例(16.75％),枕叶梗死10例(4.93％),颞叶梗死7例(3.44％).椎动脉颅外段病变以远段梗死组最多见,达53.42％,显著性高于近段梗死组的22.86％(P=0.003)和中段梗死组的33.68％(P=0.010);椎动脉颅内段病变以近段梗死组最多见,达57.14％,其次为中段梗死(41.05％),均显著性高于远段梗死组的15.07％(P均=0.000);基底动脉病变以中段梗死组最多见,达20.00％,显著性高于远段梗死组的4.11％ (P=0.002);大脑后动脉病变以远段梗死组最多见,达27.40％,显著性高于近段梗死组的5.71％(P=0.009)和中段梗死组的5.26％(P=0.000).结论 后循环梗死患者MRI所示的病变分布与椎基底动脉系统CTA显示的血管病变范围有着一定的联系.在近、中段梗死时,存在椎动脉颅内段病变的可能性更大;在远端梗死时,存在椎动脉颅外段和大脑后动脉病变的可能性更大.
目的 探討後循環梗死患者MRI所示的病變分佈與CT血管造影(computerized tomography angiography,CTA)錶現之間的聯繫.方法 納入急性後循環梗死患者,依據MRI檢查結果將梗死竈部位分為近段梗死、中段梗死和遠段梗死.所有患者均行頭頸部CTA檢查.分析後循環梗死竈分佈與椎基底動脈繫統病變部位之間的聯繫.結果 共納入急性後循環梗死患者203例,主要臨床癥狀和體徵包括單側肢體無力(77例,37.93％)、頭暈(129例,63.55％)、構音障礙(31例,15.27％)、噁心和嘔吐(61例,30.05％)、頭痛(79例,38.92％)、步態異常(50例,24.63％)、眼毬震顫(34例,16.75％)和共濟失調(21例,10.34％).近段梗死35例(17.24％):延髓梗死28例(13.79％),小腦後下部梗死7例(3.45％);中段梗死95例(46.79％):腦橋梗死80例(39.4％),小腦前下梗死15例(7.39％);遠段梗死73例(35.96％):中腦梗死6例(2.96％),小腦上梗死16例(7.88％),丘腦梗死34例(16.75％),枕葉梗死10例(4.93％),顳葉梗死7例(3.44％).椎動脈顱外段病變以遠段梗死組最多見,達53.42％,顯著性高于近段梗死組的22.86％(P=0.003)和中段梗死組的33.68％(P=0.010);椎動脈顱內段病變以近段梗死組最多見,達57.14％,其次為中段梗死(41.05％),均顯著性高于遠段梗死組的15.07％(P均=0.000);基底動脈病變以中段梗死組最多見,達20.00％,顯著性高于遠段梗死組的4.11％ (P=0.002);大腦後動脈病變以遠段梗死組最多見,達27.40％,顯著性高于近段梗死組的5.71％(P=0.009)和中段梗死組的5.26％(P=0.000).結論 後循環梗死患者MRI所示的病變分佈與椎基底動脈繫統CTA顯示的血管病變範圍有著一定的聯繫.在近、中段梗死時,存在椎動脈顱內段病變的可能性更大;在遠耑梗死時,存在椎動脈顱外段和大腦後動脈病變的可能性更大.
목적 탐토후순배경사환자MRI소시적병변분포여CT혈관조영(computerized tomography angiography,CTA)표현지간적련계.방법 납입급성후순배경사환자,의거MRI검사결과장경사조부위분위근단경사、중단경사화원단경사.소유환자균행두경부CTA검사.분석후순배경사조분포여추기저동맥계통병변부위지간적련계.결과 공납입급성후순배경사환자203례,주요림상증상화체정포괄단측지체무력(77례,37.93％)、두훈(129례,63.55％)、구음장애(31례,15.27％)、악심화구토(61례,30.05％)、두통(79례,38.92％)、보태이상(50례,24.63％)、안구진전(34례,16.75％)화공제실조(21례,10.34％).근단경사35례(17.24％):연수경사28례(13.79％),소뇌후하부경사7례(3.45％);중단경사95례(46.79％):뇌교경사80례(39.4％),소뇌전하경사15례(7.39％);원단경사73례(35.96％):중뇌경사6례(2.96％),소뇌상경사16례(7.88％),구뇌경사34례(16.75％),침협경사10례(4.93％),섭협경사7례(3.44％).추동맥로외단병변이원단경사조최다견,체53.42％,현저성고우근단경사조적22.86％(P=0.003)화중단경사조적33.68％(P=0.010);추동맥로내단병변이근단경사조최다견,체57.14％,기차위중단경사(41.05％),균현저성고우원단경사조적15.07％(P균=0.000);기저동맥병변이중단경사조최다견,체20.00％,현저성고우원단경사조적4.11％ (P=0.002);대뇌후동맥병변이원단경사조최다견,체27.40％,현저성고우근단경사조적5.71％(P=0.009)화중단경사조적5.26％(P=0.000).결론 후순배경사환자MRI소시적병변분포여추기저동맥계통CTA현시적혈관병변범위유착일정적련계.재근、중단경사시,존재추동맥로내단병변적가능성경대;재원단경사시,존재추동맥로외단화대뇌후동맥병변적가능성경대.
Objective To investigate the correlation between the distribution of lesions on MRI and the findings of computerized tomography angiography (CTA) in patients with posterior circulation infarction.Methods Patients with acute posterior circulation infarction were enrolled in the study.The sites of the infarcts were divided into proximal,middle and distal infarctions according to the results of MRI.All the patients received head and neck CTA.The correlation between the distribution of posterior circulation infarcts and the sites of vertebrobasilar system lesions was analyzed.Results A total of 203 patients with acute posterior circulation infarction were enrolled.Their primary clinical symptoms and signs were unilateral limb weakness (n =77,37.93％),dizziness (n =129,63.55％),dysarthria (n =31,15.27％),nausea and vomiting (n =61,30.05％),headache (n =79,38.92％),gait abnormal (n =50,24.63％),nystagmus (n=34,16.75％),and ataxia (n=21,10.34％).Proximal infarction (n=35,17.24％):medullary infarction (n =28,13.79％),posterior inferior cerebellar artery infarction (n =7,3.45％); middle infarction (n =95,46.79％):pontine infarction (n =80,39.4％),anterior inferior cerebellar infarction (n =15,7.39％); distal infarction (n=73,35.96％):middle cerebral infarction (n=6,2.96％),superior cerebellar infarction (n =16,7.88％),thalamic infarction (n =34,(16.75％),occipital lobe infarction (n =10,4.93％),temporal lobe infarction (n =7,3.44％).Extracranial vertebral artery lesions were most common in the distal infarction group.It reached 53.42％,and was significantly higher than 22.86％ in the proximal infarction group (P =0.003) and 33.68％ in the middle infarction group (P =0.010).Intracranlal vertebral artery lesions were most common in the proximal infarction group.It reached 57.14％,and then followed by the middle infarction (41.05％).They were all significantly higher than 15.07％ in the distal infarction group (all P =0.000).Basilar artery lesions were most common in the middle infarction group.It reached 20.00％ and was significantly higher than 4.11％ in the distal infarction group (P=0.002).Posterior cerebral artery lesions were most common in the distal infarction group.It reached 27.40％ and was significantly higher than 5.71％ in the proximal infarction group (P =0.009) and 5.26％ in the middle infarction group (P=0.000).Conclusions The range of vascular lesions of the distribution of lesions shown on MRI and the findings of CTA on vertebrobasilar artery system in patients with posterior circulation infarction had some connection.During the proximal and middle infarctions,the possibility of having intracranial vertebral artery lesions was greater; during the distal infarction,the possibility of having extracranial vertebral artery and posterior cerebral artery lesions was greater.
