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论著-头颈部

MRI病灶部位的影像 学特征预测进展性 脑梗死的临床研究*

作者:崔会娟1 李文英1 郭海云2 迟红卫3 陈 欣1 李秀玉1

所属单位:1.华北石油管理局总医院神经内科 (河北 任丘 062550) 2.华北石油管理局总医院急诊科 (河北 任丘 062550) 3.华北石油管理局总医院放射科 (河北 任丘 062550)

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摘要

目的 探讨经头颅磁共振(MRI)不 同病灶部位的影像学特征对进展性脑梗死 的预测作用,以期为临床诊断和治疗进展 性脑梗死提供客观的理论依据。方法 选 取2012年1月-2015年1月就诊于我院的脑 梗死患者作为研究观察对象,入选患者均 经MRI明确病灶部位,根据病情将其分为 进展性脑梗死组和非进展性脑梗死组,比 较各种亚型在进展性和非进展性脑梗死中 的分布情况,同时分析二者的相关性。 结果 入选患者中非进展性脑梗死组患者 86例(66.2%),进展性脑梗死组患者44例 (33.8%);两组患者中不同影像学亚型分 布情况:非进展性脑梗死组中前循环皮质 梗死率19.8%,基底节梗死率38.4%,放射 冠梗死率18.6%,后循环梗死率23.3%;而 进展性脑梗死组中前循环皮质梗死率为 50%,基底节梗死率18.2%,放射冠梗死率 11.4%,后循环梗死率20.5%,两组构成比 差异具有显著性(P<0.05);针对不同部 位脑梗死病灶亚型与进展性脑梗死的相关 性进行分析结果显示,其中前循环皮质、 放射冠及后循环梗死均与进展性脑梗死有 相关性(P<0.05)。结论 进展性脑梗死好 发于前循环皮质区,梗死部位与脑梗死进 展性有密切的关系。

Objective To investigate the predictive effect of the image characteristics of leisons different parts in cerebral magnetic resonance imaging (MRI) to progressive cerebral infarction prediction, in order to provide objective theoretical basis for its clinical diagnosis and treatment. Methods The patients with cerebral infarction who were treated in our hospital from January 2012 to January 2015 were selected as study object, their infartion lesions were clear by MRI. According to the condition, they will be divided into progressive cerebral infarction group and non -progressive cerebral infarction group, the distribution of various subtypes were compared in the progressive and non progressive cerebral infarction. And the relation between the various subtypes and the types of cerebral infarction was analyzed. Results The patients with non-progressive cerebral infarction were 86 cases (66.2%) and 44 cases of patients with progressive cerebral infarction (33.8%); The distribution of subtypes in two groups are as follow, the infartion rate of anterior circulation cortex, basal ganglia, radiation crown, posterior circulation area was 19.8%, 38.4%, 18.6%, 23.3% respectively in non-progressive cerebral infarction group; while the infartion rate of anterior circulation cortex, basal ganglia, radiation crown, posterior circulation area was 50%, 18.2%, 11.4%, 20.5% respectively in progressive cerebral infarction group , the constituent ratio of them was significantly different (P<0.05); The Analysis results showed that the different part of cerebral infarction subtypes, including anterior circulation cortex, corona radiata and posterior circulation area infarction were associated with progressive cerebral infarction correlation (P<0.05). Conclusion Progressive cerebral infarction mainly occurs in the anterior circulation cortical area, and the infarct location is closely related to the progression of cerebral infarction.

【关键词】进展性脑梗死;不同病灶部位; MRI;影像学特征;临床研究

【中图分类号】R445.2; R743.3

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2016.08.034

前言

进展性脑梗死是指颈动脉、椎动脉系统局部血管发生闭塞,出现 脑梗死的临床症状,通过临床措施进行干预,进而导致脑卒中进一步 发展,神经功能随之缺失,逐步或者阶梯式发展,在发病6小时到2周 内进一步发生恶化的缺血性卒中[1-2]。进展性脑梗死的临床病死率和致 残率都较高,大大降低了患者的生活质量,同时也给家庭和社会带来 了严重的心理负担和经济负担[3],以往对进展性脑梗死的报道虽然较 多,但多为危险因素方面的探究,本文针对入院的脑梗死患者进行病 灶部位影像学特征进行分析,探究不同亚型脑梗死对脑梗死进展性的 预测效果,现将研究报道如下。