大脑中动脉M1段闭塞后侧支循环状态与DWI-SWI不匹配相关性研究

Association of collateral circulation status to diffusion-and susceptibility weighted imaging mismatch in patients with occlusion of the M1 segment of middle cerebral artery

目的分析大脑中动脉M1段闭塞后侧支循环状态与弥散-磁敏感加权成像(DWI-SWI)不匹配的关系。方法回顾性分析我院56例大脑中动脉M1段闭塞患者DWI、T2 Flair、SWI、MRA图像,分析是否存在大脑后动脉偏利征象(PLPCA)、大脑前动脉偏利征象(PLACA)、T2 Flair高信号血管征(HVS)征象;采用DWI-ASPECT定量分析梗死范围,SWI-ASPECT定量分析颅内静脉改变,DWI-SWI不匹配定义为DWI-ASPECT评分减SWI-ASPECT评分。结果56例MCA M1段闭塞脑梗死患者中,PLPCA阳性31例,PLACA阳性16例,HVS阳性28例。PLPCA、PLACA及HVS阴性和阳性组间DWI-SWI不匹配差异具有统计学意义(P值分别为0.044、0.008、0.014)。结论大脑中动脉M1段闭塞后侧支循环建立状态与DWI-SWI不匹配相关。

Objective To analyze the relationship of collateral circulation status to diffusion and susceptibility weighted imaging mismatch(DWI-SWI mismatch).Methods Images of 56 patients with occlusion of middle cerebral artery were retrospectively reviewed,including presence or absence of prominent laterality posterior cerebral artery(PLPCA),prominent laterality anterior cerebral artery(PLACA),hyper-intense vessel sign(HVS),extension of cerebral infarction by DWI-ASPECT,extension of venous alteration by SWI-ASPECT,DWI-SWI mismatch defined DWI-ASPECT subtract SWI-ASPECT.Results Of 56 patients with occlusion of middle cerebral artery,there were 31 patients presented with PLPCA,16 patients with PLACA,28 patients with HVS,and there were statistically significant difference between presence or absence of PLPCA,PLACA,HVS and DWI-SWI mismatch(P<0.05).Conclusion Collateral circulation status was correlated to DWI-SWI mismatch,and it may play a major role in DWI-SWI mismatch after occlusion of middle cerebral artery.