MRI在脑微出血与腔隙性脑梗死相关性研究中的应用

Role of MRI in cerebral microbleeds and lacunar infarction

目的:利用MRI研究脑微出血(CMBs)与腔隙性脑梗死的相关性。方法:收集颅脑MRI受检者284例,行常规MRI序列及磁敏感加权成像(SWI)序列扫描。记录CMBs及腔隙性脑梗死位置、数目,分析CMBs、腔隙性脑梗死分布位置以及病变程度,分别统计皮层-皮层下区(CSC区)、基底节-丘脑区(DGM区)、幕下区(IT区)的CMBs、腔隙性脑梗死数目并进行相应分级;再根据脑内所有CMBs及腔隙性脑梗死数目总和对每例患者进行分级,分析两者在发病部位、病变等级之间相关性,统计各年龄组CMBs、腔隙性脑梗死发生率。利用SPSS 13.0软件对数据进行统计分析。结果:284例受检者中腔隙性脑梗死215例,CMBs 97例,腔隙性脑梗死患者CMBs发生率约40%。CMBs、腔隙性脑梗死数目分别为1～93、1～41个不等;CMBs、腔隙性脑梗死具有共同的好发部位,CSC区rs=0.450,P=0.004;DGM区,rs=0.406,P=0.000;IT区,rs=0.441,P=0.000。CSC区、DGM区、IT区的CMBs病变程度随腔隙性脑梗死病变程度的升高而升高(P=0.000);脑内所有CMBs与腔隙性脑梗死病变程度呈显著相关性(P=0.000);腔隙性脑梗死、CMBs的发生率随年龄的增大而升高。结论:颅脑MRI常规扫描序列结合SWI序列检测腔隙性脑梗死和CMBs,可以更加科学指导脑血管患者的诊断治疗、跟踪观察及预后判断。

Objective： To study the correlation between cerebral microbleeds （CMBs） and lacunar infarction by MRI of the brain. Methods.. All of 284 cases were examined brain MRI included SWI sequence. The MRI features of CMBs and lacunar infarction （location/number） were analyzed. The lesion numbers of CMBs and lacunar infarction were counted,including IT areas, DGM areas,CSC areas. Then,the grades according to the disease numbers of each area were classified. The grade according to the disease total numbers of brain was also classified. The prevalence of CMBs and lacunar infarction according to age was counted and the correlation in disease location and grade between CMBs and lacunar infarction were analysed. The data was analyzed with SPSS13.0 computer software. Results： there were 215 cases of lacunar infarction in 284 subjects,97 patients with CMBs, with the incidence of lacunar CMBs patients about 40%. CMBs, the number of lacunar infarction were 1 ~ 93, 1 ~ 41 range. CMBs and lacunar infarction have common location：CSC areas （ rs =0. 450, P =0. 004） ,DGM area （ r, =0. 406, P = 0. 000）. The lesion grade of CMBs will increase with the lesion grade of lacunar infarction of three areas（ P = 0. 000）. There was a significant correlation between CMBs and lacunar infarction all of areas in brain （ P =0. 000）. The prevalence of CMBs and lacunar infarction will increase with the patient age increase. Conclusion： MRI routine sequences with SWI sequence could detect lacunar infarction and CMBs, and could afford a more scientific guidance in diagnosis, treatment, follow-up observation and prognosis of cerebral vascular diseases.