脑梗死软脑膜侧支血管的磁敏感加权成像与临床对照研究

Clinical study of susceptibility- weighted imaging in monitoring leptomeningeal collaterals in ischemic stroke

目的分析脑梗死软脑膜侧支血管的磁敏感加权成像(susceptibility-weighted imaging,SWI)特点及其与临床的相关性。方法选择66例经临床和影像确诊的脑梗死患者进行MR检查。其中急性期26例,亚急性期29例,稳定恢复期11例。所有患者均行常规T1WI、T2WI、FLAIR、DWI及SWI扫描,其中27例行MRA检查,36例行SWI随诊。分析常规MRI及SWI图像特点。观察脑梗死软脑膜侧支血管的显示及显示程度,得出相应临床NIHSS评分,并进行相关统计学分析。结果有45例显示脑梗死软脑膜侧支血管的存在,占68%。其中急性期和亚急性期显示41例,稳定恢复期显示4例,不同时期的软脑膜侧支血管显示特点差异有显著性意义(P<0.05)。2级显示20例,显示程度与临床NIHSS评分改变呈正相关(r=0.673,P<0.01)。结论量化分析脑梗死软脑膜侧支血管的SWI特点,有助于判断脑梗死侧支循环建立的情况,对临床治疗及预后评价起到一定的指导作用。

Objective To analyze the features of susceptibility -weighted imaging （SWI） of leptomeningeal collaterals in ischemia stroke and its clinical correlation .Methods Totally 66 patients with clinically or radiologically proved cerebral in-farction, including 26 acute, 29 subacute and 11 chronic cerebral infarction , were examined with MRI .All patients re-ceived conventional sequences including T 1WI, T2WI, FLAIR, DWI and SWI.Twenty-seven patients underwent MRA , and 36 patients were followed by SWI .Features of routine MRI and SWI were studied .The presence of leptomeningeal col-laterals around the infarction was observed .The correlation between the extent of the leptomeningeal collateral and the NIH-SS score was analyzed.Results Leptomeningeal collateral was revealed by SWI in 45 out of 66 （68%） cerebral infarctions, including 41cases in acute and subacute cerebral infarction , and 4 cases in stable and chronic stage .The visualization of collateral vessels around the infarction in different stages has significant difference （P〈0.05）.Twenty cases showed de-gree 2 collaterals.There was a positive correlation between the degree of leptomeningeal collateral displayed in the SWI and the NIHSS scores （rs =0.673, P〈0.01）.Conclusion Quantitative analysis of SWI features of leptomeningeal collaterals in ischemic stroke can help determine the establishment of collateral circulation of cerebral infarction , guide the clinical treatment and evaluate the prognosis .