期刊文献+

脑分水岭梗死MRI、MRA特点及其发病机制的研究 被引量:3

Characteristics of MRI and MRA in Patients with Cerebral Watershed Infarction
下载PDF
导出
摘要 目的:探讨脑分水岭梗死(CWI)不同病变模式的MRI、MRA特点及其发病机制。方法:回顾性分析85例CWI患者,将梗死模式分为单纯性CWI、混合性CWI和多发性CWI。比较不同模式的CWI中大脑中动脉(MCA)、颈内动脉(ICA)病变情况。结果:85例CWI患者中,单纯性后分水岭梗死(PWI)6例,单纯性内分水岭梗死(IWI)11例,混合性前分水岭梗死(AWI)4例,混合性PWI 9例,混合性IWI 36例,多发性CWI 19例。MCA重度狭窄率明显高于ICA重度狭窄率(P=0.00)。单纯性IWI、混合性IWI和多发性CWI MCA重度狭窄率明显高于ICA重度狭窄率(P<0.01)。单纯性IWI、混合性AWI、混合性IWI、多发性CWI的MCA重度狭窄率均明显高于单纯性PWI和混合性PWI(P<0.05)。结论:MCA重度狭窄较ICA重度狭窄更易导致CWI,尤其是导致IWI、混合性IWI和多发性CWI;MCA重度狭窄对于前循环(颈内动脉系统)供血区的CWI影响较大;MCA重度狭窄引起狭窄远端的血流动力学障碍和微栓子清除能力下降,可能是导致CWI以及CWI合并皮质区梗死(PI)和/或穿支动脉梗死(PAI)的机制之一。 ObjectiveTo investigate the features of MRI and MRA in detecting different cerebral watershed infarction (CWI) patterns. Methods: Eighty-five CWI patients were retrospectively divided into three types including simple CWI, mixed CWI and multiple CWI. The middle cerebral artery (MCA) and internal carotid artery (ICA) stenosis were evaluated in different CWI patterns. Results: There were 6 patients with simple posterior watershed infarction (PWI), 11 patients with simple internal watershed infarction (IWI), 4 patients with mixed anterior water-shed infarction (AWI), 19 patients with mixed PWI, 36 patients with mixed IWI and 19 patients with multiple CWI. Of the 85 patients, the ratio of severe stenosis of MCA was significantly higher than that of ICA ( P=0.00). The ratio of severe stenosis of MCA was significantly higher than that of ICA in patients with simple IWI, mixed IWI and multiple CWI ( P〈0.01). The ratio of severe stenosis of MCA in patients with simple IWI, mixed AWI, mixed IWI and multiple CWI was significantly higher than that in the patients with simple PWI and mixed PWI ( P〈0.05). Conclusion: Severe stenosis of MCA is more likely to lead CWI than severe stenosis of ICA, especially in patients with IWI, mixed IWI and multiple CWI. Severe stenosis of MAC has a greater effect on CWI of anterior circulation (ICA system). Hemodynamic abnormality of the far side in patients with severe stenosis of MCA and the declined ability to eliminate micro-embolus may be of important mechanism.
出处 《神经损伤与功能重建》 2014年第3期218-221,共4页 Neural Injury and Functional Reconstruction
关键词 脑分水岭梗死 磁共振成像 磁共振血管造影 发病机制 cerebral watershed infarction magnetic resonance imaging magnetic resonance angiography mechanism
  • 相关文献

参考文献15

二级参考文献60

  • 1程道宾,王进,秦超,曾丽,郑金瓯,罗杰峰.脑分水岭梗死的临床表现及病因研究[J].中华神经医学杂志,2007,6(5):508-510. 被引量:3
  • 2张栩,李海峰,张勇,潘旭东,刘宗超.内侧分水岭梗死的临床和影像学特点及与颈动脉系统病变的关系[J].中国脑血管病杂志,2007,4(7):310-313. 被引量:7
  • 3Jorgensen L, Torvik A. Ischaemic cerebrovascular diseases in an autopsy series, part2: prevalence, location, pathogenesisand clinical course of cerebral infarcts[J]. J Neurol Sci, 1969, 9(3): 285.
  • 4Momjian-Mayor I, Baron JC. The The pathophysiology of watershed infarction in internal carotid artery disease: review of cerebral perfusion studies[J]. Stroke, 2005, 36(3): 567-577.
  • 5Chambers BR, Bladin CF. Internal watershed infarction [A]// Subcortical Stroke [M], 2nd. Oxford: Oxford Medical Publications, 2002 : 241-254.
  • 6Wong KS, Gao S, Chan YL, et al. Mechanisms of acute cerebral infarctions in patients with middle cerebral artery stenosis: a diffusion-weighted imaging and microemboli monitoring study [J]. Ann Neurol, 2002, 52(1): 74-81.
  • 7Allan H, Robert H. Adams and Victor's Principles of Neurology [M], 8th. New York: McGraw-Hill, 2005: 660-746.
  • 8Lee PH, Oh SH, Bang OY, et al, Isolated middle cerebral artery disease: clinical and neuroradiological features depending on the pathogenesis [J]. J Neurol Neurosurg Psychiatry, 2004, 75 (10): 727-732.
  • 9Bogousslavsky J, Regli F. Unilateral watershed cerebral infarcts[J]. Neurology, 1986, 36(4): 373-377.
  • 10Chaves C J, Silver B, Schlaug G, et al. Diffusion- and Perfusion- Weighted MRI Patterns in Borderzone Infarcts[J]. Stroke, 2000, 31 (6): 1090-1096.

共引文献37

同被引文献19

  • 1Goreliek PB, Wong KS, Bae HJ, et al. Large artery in- tracranial occlusive disease: a large worldwide burden but a relatively neglected frontier. Stroke, 2008, 39 ( 8 ) : 2396 -2399.
  • 2Kern R, Steinke W, Daffertshofer M, et al. Stroke recur- renees in patients with symptomatic VS asymptomatie middle eerebral artery disease. Neurology, 2005 , 65 ( 6 ) : 859- 864.
  • 3Wong KS, Gao S, Chall YL, et a l. Mechanisms of acute cerebral infarctions in patients with middle cerebral anery ste- nosis: a diffusion-weighted imaging and microemboli monito- ring study. Ann Neurol, 2002, 52(1) : 74-81.
  • 4Masuda J, Ogata J, Yutani C, et al. Artery-to-artery em- boIism from a thrombus formed in stenotic middle cerebral ar- tery. Report of an autopsy case. Stroke, 1987, 18(3) : 680-684.
  • 5Lee PH, Oh SH, Bang OY, et al. Infarct patterns in athero- sclerotic middle cerebral artery versus internal arotid artery disease. Neurology, 2004, 62(8) : 1291-1296.
  • 6Yong SW, Bang OY, Lee PH, et a l. Internal and cortical borderzone infarction: clinical and diffusion eighted imaging features. Stroke, 2006, 37(3) : 841-846.
  • 7Suh DC, Kim JK, Choi Jw, el a l. Intracranial stenting of severe symptomatic intraeranial stenosis : results of 100 con- secutive patients. AJNR Am J Neuroradiol, 2008 , 29 ( 4 ) : 781-785.
  • 8陈红兵,刘德志,葛颂,徐格林,刘新峰.大脑中动脉狭窄和闭塞致不同供血区脑梗死的对比研究[J].中国脑血管病杂志,2008,5(6):241-245. 被引量:4
  • 9许凡勇,刘志勤,肖家和,陈惠,钟福兴,叶军.慢性大动脉狭窄或闭塞性分水岭脑梗死的CT灌注分析[J].临床放射学杂志,2010,29(7):869-872. 被引量:14
  • 10王金月,刘筠,张春生,钟进,杨筠,郝彩仙,万秀芝,程金宝.CTP联合CTA对慢性脑缺血患者血流动力学的评价[J].放射学实践,2010,25(8):846-850. 被引量:8

引证文献3

二级引证文献43

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部