CAJ | 학술논문

目的：探讨磁敏感加权成像（ susceptibility－weighted imaging，SWI）技术对大面积脑梗死预后评估的临床应用价值。方法选择43例大面积脑梗死（以Adamas标准，梗死面积直径＞3 cm，并累及两个以上脑血管主干供血区）患者分别于＜7天，2周，3个月进行SWI检查，得出各阶段临床NIHSS评分。分析SWI图像特点。观察脑梗死后出血、血管内血栓和梗死周围侧支血管的显示及显示程度，并与临床NIHSS评分改变进行相关统计学分析。结果脑梗死后出血34例，占79％。其出血程度与临床NIHSS评分改变呈负相关（P＜0．01）。脑梗死血栓显示30例，占70％，血栓在责任血管的位置和长度，与临床NIHSS评分改变相关（ P均＜0．01）。31例存在脑梗死侧支血管，占72％。侧支血管的显示程度与临床NIHSS评分改变呈正相关（ P＜0．01）。结论 SWI能够显示大面积脑梗死后出血、病变区域的血管内血栓和病变周围的侧支血管，量化分析脑梗死后出血、血栓和周围的侧支血管，对临床预后评估起到一定的指导作用。
목적：탐토자민감가권성상（ susceptibility－weighted imaging，SWI）기술대대면적뇌경사예후평고적림상응용개치。방법선택43례대면적뇌경사（이Adamas표준，경사면적직경＞3 cm，병루급량개이상뇌혈관주간공혈구）환자분별우＜7천，2주，3개월진행SWI검사，득출각계단림상NIHSS평분。분석SWI도상특점。관찰뇌경사후출혈、혈관내혈전화경사주위측지혈관적현시급현시정도，병여림상NIHSS평분개변진행상관통계학분석。결과뇌경사후출혈34례，점79％。기출혈정도여림상NIHSS평분개변정부상관（P＜0．01）。뇌경사혈전현시30례，점70％，혈전재책임혈관적위치화장도，여림상NIHSS평분개변상관（ P균＜0．01）。31례존재뇌경사측지혈관，점72％。측지혈관적현시정도여림상NIHSS평분개변정정상관（ P＜0．01）。결론 SWI능구현시대면적뇌경사후출혈、병변구역적혈관내혈전화병변주위적측지혈관，양화분석뇌경사후출혈、혈전화주위적측지혈관，대림상예후평고기도일정적지도작용。
Objective To investigate the susceptibility-weighted imaging ( SWI) characters in the massive cerebral in-farction and evaluate the role of SWI in prognostic assessment of the large ischemia stroke.Methods 43 patients with mas-sive cerebral infarction,defined by the Adamas rules as the infarction diameters were bigger than 3 cm2 ,and related to more than two main vascular territory,were performed SWI within 7 days,2 weeks and 3 months.Clinical function scores were ac-quired with the NIHSS.Characteristics of routine MRI and SWI images were analyzed.Presence of hemorrhage and correla-ted arterial thrombosis and collateral circulation after massive cerebral infarction were studied.Correlation of imaging and NIHSS score changes was analyzed.Results Hemorrhage was revealed by SWI in 34 out of 43 (79%) massive cerebral in-farction.There was a negative correlation between the extent of hemorrhage and the change of NIHSS scores (P<0.01). Arterial thrombosis was found in 30 cases (70%).The proximal location of the thrombosis to the cerebral necrosis and the thrombus length were negatively correlated to the change of NIHSS scores (P<0.01).Collateral circulation was seen in 31 cases (72%).There was a positive correlation between the extent of collateral circulation displayed in the SWI and the change of NIHSS scores (P<0.01).Conclusion SWI can show the hemorrhage,correlated arterial thrombosis and the col-lateral circulation of massive ischemic stroke and can be used to measure the changes,thus is helpful in guiding the clinical prognosis.