中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2013年
2期
147-151
,共5页
大脑中动脉%狭窄%脑梗死%磁共振弥散加权成像
大腦中動脈%狹窄%腦梗死%磁共振瀰散加權成像
대뇌중동맥%협착%뇌경사%자공진미산가권성상
Middle cerebral artery%Stenosis%Cerebral infarction%Magnetic resonance diffusion weighted imaging
目的 观察大脑中动脉狭窄患者MR影像上脑梗死类型特点及分布,探讨动脉粥样硬化性大脑中动脉狭窄导致脑梗死的病理生理机制. 方法 回顾性分析武汉市中心医院神经内科自2009年1月至2010年12月收治的71例经数字减影全脑血管造影(DSA)确诊的大脑中动脉狭窄≥50％患者(均不伴有同侧颈内动脉狭窄或闭塞,具有≥1个的动脉粥样硬化危险因素)头部磁共振弥散加权像(DWI)上梗死灶的特点,对脑梗死类型进行分类分析. 结果 71例入选患者DSA显示大脑中动脉狭窄65例,大脑中动脉闭塞6例.MRI-DWI影像显示以皮质下梗死为主,其中以深穿支区域梗死和内分水岭区梗死最常见,分别为31例(43.7％)和30例(42.3％),外分水岭区梗死26例(36.6％),其中前分水岭梗死9例,后分水岭区梗死17例；其次为表浅穿支梗死14例(19.7％),散发皮质小梗死10例(14.1％),流域性梗死2例(2.8％).同一患者往往多种梗死类型并存. 结论 动脉粥样硬化性大脑中动脉狭窄可以表现为多种脑梗死类型,提示大脑中动脉狭窄导致脑梗死有不同的病理生理机制,应根据不同的病理机制采取不同的治疗策略.
目的 觀察大腦中動脈狹窄患者MR影像上腦梗死類型特點及分佈,探討動脈粥樣硬化性大腦中動脈狹窄導緻腦梗死的病理生理機製. 方法 迴顧性分析武漢市中心醫院神經內科自2009年1月至2010年12月收治的71例經數字減影全腦血管造影(DSA)確診的大腦中動脈狹窄≥50％患者(均不伴有同側頸內動脈狹窄或閉塞,具有≥1箇的動脈粥樣硬化危險因素)頭部磁共振瀰散加權像(DWI)上梗死竈的特點,對腦梗死類型進行分類分析. 結果 71例入選患者DSA顯示大腦中動脈狹窄65例,大腦中動脈閉塞6例.MRI-DWI影像顯示以皮質下梗死為主,其中以深穿支區域梗死和內分水嶺區梗死最常見,分彆為31例(43.7％)和30例(42.3％),外分水嶺區梗死26例(36.6％),其中前分水嶺梗死9例,後分水嶺區梗死17例；其次為錶淺穿支梗死14例(19.7％),散髮皮質小梗死10例(14.1％),流域性梗死2例(2.8％).同一患者往往多種梗死類型併存. 結論 動脈粥樣硬化性大腦中動脈狹窄可以錶現為多種腦梗死類型,提示大腦中動脈狹窄導緻腦梗死有不同的病理生理機製,應根據不同的病理機製採取不同的治療策略.
목적 관찰대뇌중동맥협착환자MR영상상뇌경사류형특점급분포,탐토동맥죽양경화성대뇌중동맥협착도치뇌경사적병리생리궤제. 방법 회고성분석무한시중심의원신경내과자2009년1월지2010년12월수치적71례경수자감영전뇌혈관조영(DSA)학진적대뇌중동맥협착≥50％환자(균불반유동측경내동맥협착혹폐새,구유≥1개적동맥죽양경화위험인소)두부자공진미산가권상(DWI)상경사조적특점,대뇌경사류형진행분류분석. 결과 71례입선환자DSA현시대뇌중동맥협착65례,대뇌중동맥폐새6례.MRI-DWI영상현시이피질하경사위주,기중이심천지구역경사화내분수령구경사최상견,분별위31례(43.7％)화30례(42.3％),외분수령구경사26례(36.6％),기중전분수령경사9례,후분수령구경사17례；기차위표천천지경사14례(19.7％),산발피질소경사10례(14.1％),류역성경사2례(2.8％).동일환자왕왕다충경사류형병존. 결론 동맥죽양경화성대뇌중동맥협착가이표현위다충뇌경사류형,제시대뇌중동맥협착도치뇌경사유불동적병리생리궤제,응근거불동적병리궤제채취불동적치료책략.
Objective To observe the cerebral infarction types and distributions under MRI in patients with arteriosclerotic middle cerebral artery (MCA) stenosis,and investigate the pathophysiological mechanism of cerebral infarction induced by arteriosclerotic MCA stenosis.Methods We retrospectively analyzed the infarction characteristics under MRI diffusion weighted imaging (DWI) of 71 patients with ≥50％ MCA stenosis (not associating with ipsilateral internal carotid artery stenosis or occlusion,and having at least one atherosclerosis risk factors),diagnosed by digital subtraction angiography (DSA) of the whole brain in our hospital from January 2009 to December 2010;and the cerebral infarction types were also analyzed.Results MCA stenosis was noted in 65 cases and MCA occlusion in 6 cases by DSA; MRI-DWI showed that subcortical infarctions were the most common,followed by external border-zone infarctions (n=26,36.6％) and shallow perforator infarctions (n=14,19.7％); subcortical infarctions included deep perforator infarctions (n=31,43.7％) and internal border-zone infarctions (n=30,42.3％); external border-zone infarctions included anterior border-zone infarctions (n=9) and posterior ones (n=17); shallow perforator infarctions included cortical spotty lesions (n=10,14.1％) and territorial infarctions (n=2,2.8％).The same patient had multiple infarction types.Conclusion Patients with arteriosclerotic MCA stenosis might appear various types of cerebral infarction,suggesting that MCA stenosis can lead to different pathophysiological mechanisms of cerebral infarction; therefore,different treatments should be adopted accordingly.
