摘要
目的探讨大脑中动脉(MCA)及其分支血栓对脑组织梗死范围的影响以及栓子的演变过程。方法回顾性分析MR血管成像(MRA)显示的60例一侧MCA主干或分支闭塞的病人资料。根据磁敏感加权成像(SWI)上显示有无磁敏感征(SVS),将病人分为伴有SVS组(41例)和不伴有SVS组(19例)。采用t检验、Mann-Whitney U检验、卡方检验和Fisher确切概率法及单因素方差分析比较伴有和不伴有SWI显示的SVS的病人情况,以及血栓长度对扩散加权成像(DWI)显示的梗死范围的影响,并随访评价采用随机数表法随机抽取的20例伴有SVS病人的栓子的演变。结果 2组病人的一般临床资料中性别构成、年龄、房颤、高血脂、糖尿病及血管闭塞侧别比较差异均无统计学意义(均P>0.05)。伴有SVS组病人发病到MRI检查的时间明显短于不伴有SVS组;不伴有SVS组的收缩压和舒张压明显高于伴有SVS组;伴有SVS组的美国国立卫生研究院卒中量表(NIHSS)评分明显高于不伴有SVS组(均P<0.05)。与不伴有SVS的病人比较,伴有SVS病人的梗死范围较大(P=0.000)。3个级别梗死的血栓长度差异有统计学意义(F=3.338,P=0.04),且1级梗死病人的栓子长度显著大于3级梗死病人的栓子长度(P=0.011)。20例伴有SVS的随访病人中有17例复查时SVS消失,复查时NIHSS评分明显低于最初检查时的评分(t=4.52,P=0.04)。结论 SVS更常见于缺血性病人的急性期,而且可反映血栓的成分。SVS的存在提示病人的临床情况更差,SVS的消失提示病人预后较好。
Objective To study 1） the relationship between the thrombus in middle cerebral artery （MCA） or its branches and the ishcemic area and 2） the evolution of the thrombus. Methods A total of 60 patients with occlusion of middle cerebral artery or its branches on MR angiography were retrospectively included in our study. According to the presence of susceptibility sign （SVS） or not, the patients were divided into two groups. The SVS, the length of the thrombus on SWI, and range of the ischemic infarction on diffusion weighted imaging （DWI） were evaluated using t test, Mann-Whitney U test, one-way ANOVA, chi-square and Fisher exact test. 20 cases with SVS were selected with a random number table method for followed up study to see the evolution of the thrombus. Result There were no statistical differences in sex, age, presence of atrial fibrillation, hyperlipemia, diabetes, and side of artery occlusion between two groups （all P〉0.05）. The time from symptom onset to MRI examination was much shorter in patients with SVS than without （P=0.02）. The systolic and diastolic blood pressures were statistical higher in patients without SVS than that of with SVS （P〈0.05）. The NIHSS in patients with SVS was higher than that of without （P=0.01）. The infarction extent in patients with SVS was larger than that without（P=0.000）. The length of the thrombus in the group with a large infarction was statistically longer than that of the group with the small infarction （P=0.004）. In the 20 cases with follow-up MRI, disappearance of SVS on SWI was seen in 17 cases and the NIHSS was decreased compared to that of the initial time （t=4.52,P=0.04）. Conclusions The susceptibility vessel sign was much more commonly seen in the acute or sub-acute stage of ischemic stroke. The presence of SVS indicates more severe clinical status and the disappearance of SVS implicates good prognosis.
出处
《国际医学放射学杂志》
2014年第4期307-310,322,共5页
International Journal of Medical Radiology
基金
中国博士后基金(201150M1573)
关键词
磁敏感征
磁敏感加权成像
血栓
缺血性脑卒中
大脑中动脉
Susceptibility vessel sign
Susceptibility weighted imaging
Thrombus
Ischemic stroke
Middle cerebral artery
