CAJ | 학술논문

目的：探讨颈动脉闭塞患者Willis动脉环的完整性与磁共振FLAIR血管高信号征是否存在相关性。方法颈动脉闭塞患者61例，入院1 h内完成测量NIHSS评分，24 h内完成头颅磁共振T1、T2、DWI、FLAIR序列及头颅＋颈部的磁共振血管成像检查。采用Stephane Olindo法对入组患者磁共振FV H进行评分，分为低 FV H评分组（FVH＜4，包括FVH＝0）和高FVH评分组（FVH≥4）。Willis环形态分为四型，Ⅰ型：Willis环完整；Ⅱ型：Willis环前循环完整后循环不完整；Ⅲ型：Willis环前循环不完整后循环完整；Ⅳ型：Willis环前、后循环均不完整。结果61例患者中低FV H评分组29例（48．30％），高FV H评分组32例（51．70％）。两组间Willis环的总体形态分布比例存在差异（c2＝9．711，P＜0．05）；两组梗死体积分别为47．7（11．9～97．3）mL 和10（8～13）mL ，NIHSS评分则分别为10（8～13）分和4（3～7）分，差异均有统计学意义（P＜0．05）。一般危险因素差异无统计学意义（P＞0．05）。结论颈动脉闭塞患者 Willis环交通支的开放与 FVH存在显著相关性，Willis环侧支循环开放可能是FV H产生的重要机制。
목적：탐토경동맥폐새환자Willis동맥배적완정성여자공진FLAIR혈관고신호정시부존재상관성。방법경동맥폐새환자61례，입원1 h내완성측량NIHSS평분，24 h내완성두로자공진T1、T2、DWI、FLAIR서렬급두로＋경부적자공진혈관성상검사。채용Stephane Olindo법대입조환자자공진FV H진행평분，분위저 FV H평분조（FVH＜4，포괄FVH＝0）화고FVH평분조（FVH≥4）。Willis배형태분위사형，Ⅰ형：Willis배완정；Ⅱ형：Willis배전순배완정후순배불완정；Ⅲ형：Willis배전순배불완정후순배완정；Ⅳ형：Willis배전、후순배균불완정。결과61례환자중저FV H평분조29례（48．30％），고FV H평분조32례（51．70％）。량조간Willis배적총체형태분포비례존재차이（c2＝9．711，P＜0．05）；량조경사체적분별위47．7（11．9～97．3）mL 화10（8～13）mL ，NIHSS평분칙분별위10（8～13）분화4（3～7）분，차이균유통계학의의（P＜0．05）。일반위험인소차이무통계학의의（P＞0．05）。결론경동맥폐새환자 Willis배교통지적개방여 FVH존재현저상관성，Willis배측지순배개방가능시FV H산생적중요궤제。
Objective To research the correlation of FVH to the Integrity of circle of Willis in acute anterior cir‐culation ischemic stroke patients with carotid artery occlusion .Method 61 acute anterior circulation ischemic stroke patients with carotid artery occlusion ,were enrolled as subjects .All subjects completed the text of National Institute of Health stroke scale(NIHSS)in one hour ,and the brain T1WI ,T2DWI ,DWI ,FLAIR ,Intracranial vascular TOF‐MRA and neck vascular CE‐MRA in 24 hours .Using Stephane Olindo method calculate FVH score ,and divided into FVH<4(n=29)and FVH≥4(n=32)groups .Willis’ circle was divided into four types which were TypeⅠ ,TypeⅡ ,TypeⅢ ,and TypeⅣ .Result In the 61 patients ,FVH<4 group were 29(48 .30% ) ,and FVH≥4(n=32)group were 32(51 .70% ) .There were statistical significantly differences between the two groups with the Integrity of the circle of willis(n=9 .711 ,P<0 .05) .The infarct volume in two groups were 47 .7(11 .9~97 .3)mL and 10(8~13) mL(H=24 .94 ,P<0 .05) ,and the NIHSS scores were 10(8~13)和 4(3~7)(H=128 .00 ,P<0 .05) .Both infarct volume and NIHSS score there were statistal significantly differences .There were no statistical significantly differ‐ences(P>0 .05)on the general risk factors as age ,sex ,hypertension ,diabetes ,hyperlipidemia ,and smoking history . Conclusion The state of transportation arteries of Circle of Willis ,especially anterior communicating artery ,is signifi‐cantly associated with FVH ,and may be an important mechanism in the formation of FVH .