大脑中动脉粥样硬化性脑梗死患者急性期MRI表现及其病理生理机制分析

MRI Characteristics and Pathophysiological Mechanisms of Acute Cerebral Infarction in Middle Cerebral Artery Atherosclerosis

目的:回顾性分析大脑中动脉粥样硬化性脑梗死患者急性期的MRI表现,并探讨其病理生理机制。方法:收集38例大脑中动脉粥样硬化性脑梗死患者的MRI资料,据梗死灶的形态学表现分型并统计例数。结果:38例患者中,多发性脑梗死11例(28.9%),单发性脑梗死27例(71.1%);分水岭脑梗死或伴其他类型梗死13例(34.2%),流域性脑梗死或伴其他类型梗死8例(21.1%),纹状体内囊梗死或伴其他类型梗死6例(15.8%),半卵圆区梗死或伴其他类型梗死5例(13.2%),单发腔隙性脑梗死4例(10.5%),单发弥散性多发性点状脑梗死2例(5.3%)。结论:大脑中动脉粥样硬化性脑梗死的MRI表现各异,并有其不同的病理生理机制,可根据脑梗死MRI表现初步判断其发病机制并予以相应治疗。

Objective：To Retrospectively analyze the MRI property of patients with acute cerebral infarction in middle cerebral artery atherosclerosis and explore the underlying pathophysiological mechanisms. Methods： The MRI data of 38 patients were retrospectively analyzed according to the types of infarcts. Results： Among all 38 patients with middle cerebral artery stenosis, 11 cases showed multiple cerebral infarcts （29.0%）, 27 had a single infarct （71.0%）; 13 had watershed infarcts （34.2%）; 6 had striato-capsular infarcts （15.8%）; 8 had territorial infarcts （21. 1%）; 5 patients had semioval infarcts 5 （13. 2%）; 4 had lacunar infarcts （10. 5%） and 2 had MSSI （5.3%）. Conclusion：The MRI manifestations of middle cerebral artery atheroselerotic cerebral infarction vary perhaps due to different pathophysiological mechanisms. The pathogenesis and related treatment should be determined in accordance with the MRI characteristic of cerebral infarction.