分水岭脑梗死的临床研究及磁共振特征分析

Clinical analysis of cerebral watershed infarction and characteristics of magnetic resonance

目的探讨分水岭脑梗死(CWSI)的临床特征、治疗、头部磁共振成像(MRI)及磁共振血管成像(MRA)特征和临床应用价值。方法对我院48例分水岭脑梗死患者回顾分析。结果治愈26例,显著进步12例,好转8例;恶化、死亡各1例;MRI显示皮质前型8例,皮质后型14例,皮质下型24例,混合性2例;MRA显示颈内动脉狭窄或闭塞17处,大脑前动脉或闭塞10处,中动脉狭窄或闭塞8处,大脑后动脉6处,椎基底动脉6处。结论全身血压下降、颈内动脉等脑主干动脉狭窄或闭塞引起分水岭区域血液动力学障碍、血流改变以及微栓塞、Willis环完整性是主要发病原因,磁共振成像对分水岭脑梗死能提供更多的影像学信息。

Objective To investigate the clinical features of cerebral watershed infarction（CWSI）,as well as characteristics of the head magnetic resonance imaging（MRI） and magnetic resonance angiography（MRA） and its clinical application value.Methods Totally 48 cases of cerebral watershed infarction were analyzed retrospectively in Changzhou Wujin People＇s Hospital.Results Some 26 cases were cured,12 cases were significant improved,8 cases were improved.MRI showed that 8 cases were cortex former type,14 cases were cortex after type,24 cases were cortex under type,2 cases were mixed type;MRA showed that 17 places of the internal carotid artery stenosis or occlusion,10 places of anterior cerebral artery occlusion,8 places of artery stenosis or occlusion,both of the posterior cerebral artery and the vertebrobasilar were 6 places.Conclusion The decline in blood pressure systemically,carotid artery cerebral artery stenosis or occlusion of the trunk causing hemodynamic impairment of the watershed area,changes in blood flow and microembolization Willis ring＇s integrity are the main causes,magnetic resonance imaging of cerebral watershed infarction can provide more imaging information.