不同部位脑分水岭梗死MRI表现及与颅内外大动脉狭窄相关性研究

MRI findings of different parts of cerebral infarction and its correlation with intracranial and extracranial arterial stenosis

目的探讨利用颈部超声、磁共振血管成像(MRA)等检查手段,统计分析脑分水岭梗死(CWI)的颅内外血管影像学资料,不同部位脑分水岭梗死的MRI表现,以及两者的相关性,为临床个体化治疗和预防提供理论依据。方法选取200例脑岭梗死患者作为此次研究对象,经过MRI等检查确诊100例患者为脑分水岭梗死,另100例患者为非脑分水岭梗死,联合所有检查结果分析CWI组与非CWI组患者病灶侧颅脑内外动脉的狭窄发生率情况。结果 (1)脑分水岭梗死组颈内动脉狭窄37例(37.0%)、颈外动脉脑狭窄75例(75.0%)、颅内动脉狭窄33例(33.0%);非脑分水岭梗死组颈内动脉狭窄73例(73.0%)、颈外动脉脑狭窄68例(68.0%)、颅内动脉狭窄62例(62.0%)。脑分水岭梗死组与非脑分水岭梗死组患者之间的颈外动脉比较,差异无统计学意义;脑分水岭梗死组与非脑分水岭梗死组患者之间的颅内动脉和颈内动脉比较,差异具有统计学意义(P<0.05)。(2)颈内动脉狭窄及大脑中动脉狭窄的发生率分为为60.0%、55.0%,要明显高于其他血管狭窄类型,差异具有统计学意义(P<0.05)。结论不同类型的脑分水岭梗死可以提示不同部位的动脉狭窄和闭塞,脑分水岭梗死与颈内动脉狭窄和大脑中动脉狭窄有这咩切的关系。MRI检查无创无辐射,安全可靠,结合颅内外大动脉狭窄程度的分析可作为诊断的重要指标,能及早为临床相关治疗方案的确定提供依据。

Objective To explore the use of neck ultrasonography,magnetic resonance angiography(MRA) examination methods,statistical analysis of cerebral watershed infarction(CWI) data of intracranial vascular imaging,MRI manifestations of cerebral watershed infarction at different locations,and the correlation between them,and provide a theoretical basis for clinical individualized treatment and Prevention.Methods 200 cases of cerebral watershed infarction were selected as the research object,through the MRI examination confirmed 100 cases of patients with cerebral watershed infarction,100 patients with non cerebral watershed infarction,combined with all the test results analysis of stenosis rate of CWI group and non CWI group of patients with ipsilateral brain artery inside and outside the.Results He cerebral watershed infarction group of internal carotid artery stenosis in 37 cases(37.0%),external carotid artery cerebral stenosis in 75 cases(75.0%),intracranial artery stenosis in 33 cases(33.0%);non cerebral watershed infarction group internal carotid artery stenosis in 73 cases(73.0%),external carotid artery cerebral stenosis in 68 cases(68.0%),intracranial artery stenosis in 62(62.0%).Between cerebral watershed infarction group and non cerebral watershed infarction in patients with carotid artery is no comparison,no statistically significant difference;comparison between cerebral watershed infarction group and non cerebral watershed infarction patients with intracranial artery and internal carotid artery are different,with statistical significance(P<0.05).The incidence of internal carotid artery stenosis and middle cerebral artery stenosis was 60% and 55.0%,which was significantly higher than that of other vascular stenosis types,and the difference was statistically significant(P<0.05).Conclusion Different types of cerebral watershed infarction can be used to indicate the stenosis and occlusion of different parts of the brain,and the relationship between cerebral watershed infarction and internal carotid artery stenosis and middle cerebral artery stenosis.MRI is non-invasive,safe and reliable,and it can be used as an important index for the diagnosis of intracranial and extracranial artery stenosis.