MRI病灶部位的影像学特征预测进展性脑梗死的临床研究

The Clinical Research of Prediction for Progressive Cerebral Infarction with Imaging Features of Lesions in MRI

目的探讨经头颅磁共振(MRI)不同病灶部位的影像学特征对进展性脑梗死的预测作用,以期为临床诊断和治疗进展性脑梗死提供客观的理论依据。方法选取2012年1月-2015年1月就诊于我院的脑梗死患者作为研究观察对象,入选患者均经MRI明确病灶部位,根据病情将其分为进展性脑梗死组和非进展性脑梗死组,比较各种亚型在进展性和非进展性脑梗死中的分布情况,同时分析二者的相关性。结果入选患者中非进展性脑梗死组患者86例(66.2%),进展性脑梗死组患者44例(33.8%);两组患者中不同影像学亚型分布情况:非进展性脑梗死组中前循环皮质梗死率19.8%,基底节梗死率38.4%,放射冠梗死率18.6%,后循环梗死率23.3%;而进展性脑梗死组中前循环皮质梗死率为50%,基底节梗死率18.2%,放射冠梗死率11.4%,后循环梗死率20.5%,两组构成比差异具有显著性(P<0.05);针对不同部位脑梗死病灶亚型与进展性脑梗死的相关性进行分析结果显示,其中前循环皮质、放射冠及后循环梗死均与进展性脑梗死有相关性(P<0.05)。结论进展性脑梗死好发于前循环皮质区,梗死部位与脑梗死进展性有密切的关系。

Objective To investigate the predictive effect of the image characteristics of leisons different parts in cerebral magnetic resonance imaging （MRI） to progressive cerebral infarction prediction, in order to provide objective theoretical basis for its clinical diagnosis and treatment.Methods The patients with cerebral infarction who were treated in our hospital from January 2012 to January 2015 were selected as study object, their infartion lesions were clear by MRI. According to the condition, they will be divided into progressive cerebral infarction group and non -progressive cerebral infarction group, the distribution of various subtypes were compared in the progressive and non progressive cerebral infarction. And the relation between the various subtypes and the types of cerebral infarction was analyzed.Results The patients with non-progressive cerebral infarction were 86 cases （66.2%） and 44 cases of patients with progressive cerebral infarction （33.8%）; The distribution of subtypes in two groups are as follow, the infartion rate of anterior circulation cortex, basal ganglia, radiation crown, posterior circulation area was 19.8%, 38.4%, 18.6%, 23.3% respectively in non-progressive cerebral infarction group; while the infartion rate of anterior circulation cortex, basal ganglia, radiation crown, posterior circulation area was 50%, 18.2%, 11.4%, 20.5% respectively in progressive cerebral infarction group , the constituent ratio of them was significantly different （P〈0.05）; The Analysis results showed that the different part of cerebral infarction subtypes, including anterior circulation cortex, corona radiata and posterior circulation area infarction were associated with progressive cerebral infarction correlation （P〈0.05）.Conclusion Progressive cerebral infarction mainly occurs in the anterior circulation cortical area, and the infarct location is closely related to the progression of cerebral infarction.