幕上分水岭区脑梗死形态与颈动脉狭窄的关系研究

Relationship between different shapes of suparatentorial cerebral border-zone infarction and the atherosclerosis of carotid artery

目的:探讨不同形态幕上分水岭区脑梗死与颈动脉狭窄的关系。方法:回顾性分析37例幕上分水岭区脑梗死患者的头MRI和头颈CTA图像(其中1例为双侧)。结果:根据形态将幕上脑分水岭区梗死分为条/链状、点片状。条/链状梗死患者颈动脉狭窄程度更严重,在22例中有13例(占59.1%)伴同侧颈动脉的严重狭窄或闭塞;点片状梗死患者颈动脉狭窄程度较轻,多为轻-中度狭窄(占62.5%)。二者差异具统计学意义。结论:血流动力学减弱在条、链状分水岭区脑梗死中起主要作用,而动脉-动脉栓塞在点片状梗死中起较大的作用。

Objective： To investigate the relationship between the different shapes of supratentorial cerebral border-zone infarction（BZI） and the presence of carotid artery stenosis.Methods： Retrospectively analysised the MRI and CTA images of 37 patients who had BZI,one of which is bilateral.Results： BZI was divided into 2 subtypes depending on the shapes of the infarction：Strip/Chain-like and Mottled shapes.Patients with Strip/Chain-like shaped infarction always presented more severe stenosis.There were 13 patients with Strip/Chain-like shaped infarction presented severe ICA stenosis/occlusion,and patients with Mottled shaped infaction always presented moderate stenosis.Conclusion： Strip/Chain-like shaped infarcts are caused mainly by hemodynamic compromise,whereas embolic pathogenesis appears to contribute more to the genesis of Mottled shaped infarcts.