脑梗死与皮质下缺血性血管性痴呆MRI相关研究

Correlative study on MRI manifestations between cerebral infarction and subcortical ischemic vascular dementia

目的深入研究皮质下多发性脑梗死磁共振成像(MRI)表现与皮质下缺血性血管性痴呆(SIVD)之间关系。方法对照分析98例SIVD患者及作为对照的68例无痴呆型脑梗死患者MRI表现。结果 SIVD组与对照组比较:1)SIVD组中丘脑、额顶颞叶皮质下白质、侧脑室体部旁前部白质、半卵圆中心前部及基底节区豆状核、尾状核、内囊膝部发生率均明显高于对照组(P<0.05);2)SIVD组中丘脑、额颞叶皮质下白质、侧脑室体部旁前部白质、半卵圆中心前部及基底节区豆状核、尾状核、内囊前支、外囊平均脑梗死灶数目均明显高于对照组(P<0.05);3)SIVD组中丘脑、额颞叶皮质下白质、侧脑室体部旁前部白质、半卵圆中心前部及基底节区豆状核、内囊前支平均脑梗死灶体积均明显大于对照组(P<0.05)。结论皮质下血管性痴呆的发病与MRI检查显示脑梗死灶的位置、数目、体积有着密切的关联。

Objective To further study the relationship of magnetic resonance imaging （MRI） manifestations between subcortical multiple cerebral infarction and subcortical ischemic vascular dementia （SIVD）. Methods MRI manifestations of 98 pa- tients with SIVD and 68 patients with cerebral infarction without dementia as controls were comparatively analyzed in this work. Results In comparison of the patients in SIVD group to those in control group, the results were as follows ： 1 ） The incidence in the thalamus, subcortical white matter of frontal temporal lobe, anterior white matter of lateral ventricle body, the forepart of cen- trum semiovale, the basal ganglia, caudate nucleus, lentiform nucleus, or internal capsule was significantly higher in SIVD group than that in control group （ P 〈 0.05 ） ; 2） the average number of focal cerebral infarction in the thalamus, subcortical white mat- ter of frontal temporal lobe, anterior white matter of lateral ventricle body, the forepart of centrnm semiovale, the basal ganglia, caudate nucleus, lentiform nucleus, preramus of internal capsule, or capsula externa was significantly higher in SIVD group than that in control group （ P 〈 0.05 ） ; 3 ） the average volume of cerebral infarcts in the thalamus, subcortical white matter of frontal temporal lobe, anterior white matter of lateral ventricle body, or the forepart of centrum semiovale was significantly higher in SIVD group than that in control group （ P 〈 0.05）. Conclusion The incidence of SIVD is closely related to location, number, and size of the cerebral infarction as shown by MRI examination.