急性脑梗死患者脑微出血特征分析

Analysis of characteristics of cerebral microbleeds in patients with ischemic stroke

目的应用磁敏感加权成像序列评价急性脑梗死患者脑内微出血灶分布及分级特征。方法连续纳入350例急性脑梗死患者,常规扫描头颅磁敏感加权成像序列,使用MARS量表对微出血灶进行分区并根据其数量评级,对结果进行统计分析。结果所有患者中检出微出血灶者共108例(30.86%),伴微出血灶患者收缩压显著高于未伴微出血灶患者(P=0.003)。深部脑组织型微出血灶的病例最多,脑表面型次之(44.44%vs 34.26%),但前者分级更高(P=0.008),幕下型比例约11.11%,多区域型比例最小(10.19%),但在所有区域中分级最高(P=0.001)。位于脑梗死区外的微出血灶数显著高于梗死区内者(P=0.018)。具有微出血灶的腔隙性脑梗死患者显著多于非腔隙性脑梗死者(P=0.019)。结论在磁敏感加权图像上急性脑梗死患者微出血灶分布和分级具有一定特征,可为临床医生制定预防措施提供有益信息。

Objective To investigate the distribution and classification characteristics of cerebral microbleeds （CMBs） in pa- tients with ischemic stroke by using susceptibility weighted imaging （SWI）. Methods 350 patients with ischemic stroke were re- cruited consecutively and nuderwent MR imaging with SWI Conventionally. We measured anatomical distribution of CMBs using MARS and graded according to its number, then we investigated the characteristics. Results CMBs were detected in 108 of 350 cases （30.86%）. The systolic blood pressure of patients with CMBs was significantly higher than that of other patients. CMBs were most prevalent in the deep region （44.44%）, followed by lobar （34.26%）, infratentorial regions （11.11% ） and multiple regions （ 10. 19% ）. The rank of CMBs in deep region was higher than that in lobar （ P = 0. 008 ） and the last region was the highest one （ P =0,001 ）. The number of CMBs in the cerebral infarction area were significantly lower than those outside the infarction area （ P =0. 018）. CMBs in patients with lacunar infarction were significantly more than those in other ptients. Conclusion The distribution and classification of CMBs in patients with ischemic stroke have some characteristic manifestations on SWI, witch may provide useful information for clinicians to develop preventive measures.