PWI评估不同期幕上脑梗死体积与交叉性小脑机能联系不能的关系

Perfusion weighted imaging assessment of the relationship between volume of cerebral infarction and crossed-cerebellar diaschisis in different stages of cerebral infarction

目的:采用磁共振脑灌注成像(PWI)评估不同期幕上脑梗死体积(CIV)与交叉性小脑机能联系不能(CCD)的关系。方法:选取单侧幕上脑梗死患者81例,其中急性期41例,亚急性期19例,慢性期21例。所有患者均行双侧小脑半球PWI和MRI常规序列检查。记录并计算幕上CIV和幕下小脑不对称指数(AI)。根据是否出现CCD将患者分为CCD阳性组和CCD阴性组,比较两组患者不同期幕上CIV的差异,分析CCD阳性患者不同期幕上CIV与幕下AI值的相关性。结果:慢性期、亚急性期和急性期患者CCD的发生率分别为52.38%、36.84%和41.46%。急性期和慢性期CCD阳性患者的幕上CIV分别为(79.22±56.05)和(91.58±58.11)cm3,显著高于CCD阴性患者[分别为(45.52±36.08)和(17.75±16.53)cm3],差异均有统计学意义(P均<0.05)。亚急性期CCD阳性患者CIV值[(50.32±34.79)cm3]高于CCD阴性患者[(19.55±24.75)cm3],但差异无统计学意义(P>0.05)。慢性期幕上CIV与幕下AI值呈正相关(r=0.878,P<0.05),急性期和亚急性期幕上CIV与幕下AI值均无明显相关性(P均>0.05)。结论:急性期和慢性期幕上CIV与CCD的发生有关,且慢性期CCD阳性患者幕上CIV与CCD严重程度呈正相关。

Objective：To assess the relationship between volume of cerebral infarction（CIV） and crossed-cerebellar diaschisis（CCD） in different stages of cerebral infarction using perfusion weighted imaging（PWI）.Methods：81 patients with supratentorial cerebral infarction of final diagnosis were selected,including 41 cases of acute cerebral infarction,19 cases of subacute infarction and 21 cases of chronic infarction who all had undergone PWI and conventinal MR scans.We measured the cerebellar asymmetry index（AI） and supratentorial CIV of all patients.All of patients were divided into two groups：one of the patients with CCD and other one of patients without CCD.The discrepancy of CIV of two groups in different stages was compared and the dependablity between supratentorial CIV and cerebellum AI of patients with CCD was analyzed.Results：The ratio of CCD in chronic,subacute and acute stage was respectively 52.38%、36.84% and 41.46%.Supratentorial CIV in acute and chronic stage of patients with CCD,which was respectively（79.22±56.05） and（91.58±58.01）cm3,which was significantly higher than that of patients without CCD respectively showing（45.52±36.08） and（17.75±16.53）cm3（P〈0.05）.There was positive correlation between volume of supratentorial CIV and cerebellum AI（r=0.878,P〈0.05）.Conclusion：There was positive correlation between supratentorial CIV and incidence rate of CCD.