58例大脑中动脉狭窄或闭塞患者临床特点分析

Infarct pattern analysis in 58 patients with middle cerebral artery stenosis or occlusive disease

目的探讨大脑中动脉狭窄或闭塞患者的MRI影像上脑梗死模式与临床表现类型特点。方法58例经DSA确诊的大脑中动脉狭窄或闭塞患者,依据头部MRI成像所示梗死灶的特点及临床表现进行分类。结果58例大脑中动脉狭窄或闭塞患者根据影像学分类,深部小梗死最常见,占55.17%,交界区梗死占24.14%,皮层区域内梗死占22.41%,有7例在MRI影像上正常。临床类型分型,部分前循环脑梗死占48.28%,腔隙性脑梗死占22.41%,完全前循环脑梗死占5.17%。结论大脑中动脉狭窄或闭塞患者MRI影像上脑梗死模式以深部小梗死为主;大脑中动脉狭窄或闭塞患者临床表现类型以部分前循环脑梗死为主,亦可仅表现为头晕、头痛或无症状。

Objective To investigate lesion patterns on MRI and stroke patterns of symptomatic patients with middle cerebral artery stenosis or occlusive disease. Methods 58 patients with middle cerebral artery stenosis or occlusive disease diagnosed by DSA, They were performed by the lesions on MRI and clinical symptoms. Results It showed that the occurance of clinical symptoms in 58 patients with middle cerebral artery stenosis or occlusive disease is partial anterior circulation infarction （48.28%）, lacunar cerebral infarction （22. 41% ） ,total anterior circulation infarction（5. 17% ） and a part of patients that occurred headach,dizziness ,TIA or normality. According to the lesions on MRI, 58 patients with middle cerebral artery stenosis or occlusive disease were categorized as corical territory infarction （22. 41% ） ,border zone infarction（24. 14% ） ,perforating artery infarction（55.17% ） and normality（ 12.07% ）. Conclusion The most common stroke patterns of middle cerebral artery stenosis or occlusive patients is perforating artery infarction. The main subpattern of clinical symptomical pattern of severe stenosis or occlusive of middle cerebral artery is partial anterior circulation infarc- tion,and a part of patients only occurred headach ,dizziness, TIA or normality.