半卵圆中心小梗死临床及影像学的对比性研究

Comparative research of the clinical and imaging features of the small centrum ovale infarcts

目的通过与基底节区小梗死比较,阐明半卵圆中心小梗死的临床及影像学特征。方法回顾性连续纳入2014年1月至2015年9月辽宁省人民医院发病1周内入院的MR扩散加权成像轴面上显示半卵圆中心小梗死的患者46例,以157例基底节区小梗死作为对照,比较分析半卵圆中心小梗死与基底节区小梗死的血管危险因素、临床特征及影像学资料的差异。结果半卵圆中心小梗死的平均年龄为(69±12)岁,其中男27例。基底节区小梗死的平均年龄为(66±11)岁,其中男98例。半卵圆中心小梗死与基底节区小梗死患者的血管危险因素、临床特征及影像学资料比较:高血压[63.0%(29例)比43.3%(68例),P=0.018]、冠心病[4.3%(2例)比17.8%(28例),P=0.042]、心房颤动[15.2%(7例)与5.7%(9例),P=0.036]、单侧肢体无力[17.4%(8例)比6.4%(10例),P=0.021]、美国国立卫生研究院卒中量表评分[2(1,3)分比3(2,5)分,P=0.002]、梗死灶直径[(6±3)mm与(10±3 mm),P<0.01]、同侧大脑中动脉(MCA)狭窄[4.3%(2例)比24.2%(38例),P=0.006]、伴发对侧颅内动脉狭窄[4.3%(2例)比17.8%(28例),P=0.042]差异均有统计学意义。结论与基底节区小梗死比较,半卵圆中心小梗死的心房颤动患病率较高,入院时神经功能缺损程度较轻,梗死灶直径较小,同侧MCA狭窄及伴发对侧颅内动脉狭窄患病率较低。

Objective To clarify the clinical and imaging features of the small eentrum ovale infarcts by comparing with the small basal ganglia infarcts. Methods Forty-six consecutive patients with small eentrum ovale infarct showed on the axial MR diffusion weighted imaging admitted to hospital within one week after onset were enrolled retrospectively. One hundred fifty-seven patients with small basal ganglia infarct were used as a control group. The differences of demography, vascular risk factors, clinical features, and imaging data in patients with small centrum ovale infarct and small basal ganglia infarct were compared and analyzed. Results The mean age of small centrum ovale infarct was 69 ± 12 years, among them, 27 patients were male. The mean age of small basal ganglia infarct was 66 ± 11 years, among them, 98 were male. The vascular risk factors,clinical features and imaging data of the small centrum ovale infarct and the small basal ganglia infarct were compared. There were significant differences in hypertension （63.0% [ n = 29] vs. 43.3% [n=68],P=0. 018）,coronaryheartdisease （4.3% [n=23 vs. 17.8% [n=28],p=0.042）,atrial fibrillation （15.2% [n =7] vs. 5.7% [n =9] ,P =0.036）,single limb weakness （ 17.4% [ n = 8 ] vs. 6.4% [ n = 10 ], P = 0. 021 ）, National Institutes of Health Stroke Scale score （2 [ 1,3] vs. 3 [2,5] ,P =0. 002） ,infarct diameter （ 6 ±3 mm vs. 10 ± 3 ram, P 〈 0.01 ）, ipsilateralmiddle cerebral artery（MCA）stenosis （4.3% [n=2] vs. 24.2% [n=38] ,P =0.006）,and accompanied with eontralateral intracranial artery stenosis （ICAS） （4.3% In=2] vs. 17.8% [n=28 ],P=0.042）. Conclusions Compared with the small basal ganglia infarcts, the prevalence of atrial fibrillation of the small centrum ovale infarcts was higher. The degree of neurological deficits on admission was milder,the diameter of the infarct was smaller,and the incidences of ipsilateral MCA stenosis and contralateral ICAS were lower.