多模态CT在两种常见病因所致急性脑梗死中的对比研究

A Comparative Study of Multimodal CT in Acute Cerebral Infarction Caused by Two Common Causes

目的:探讨多模态CT中两种常见病因所致急性脑梗死的特征差异。方法:回顾性分析动脉粥样硬化血栓形成(AT)患者29例,心源性栓塞(CE)患者13例,对比两组患者多模态CT检查结果并进行统计学分析。结果:AT组和CE组患者多节段栓子的发生率分别为41.4%和7.7%,差异有统计学意义(χ^(2)=4.766,P<0.05)。两组患者累及大脑中动脉的差异无统计学意义(χ^(2)=0.073,P>0.05)。AT组患者区域软脑膜评分高干CE组[18(16,19)分vs.17(12,17)分],差异有统计学意义(Z=-2.201,P<0.05)。A T组患者缺血半暗带的体积小于CE组[47(9,118)ml vs 5.73(35,99)ml],差异无统计学意义(Z=-0.872,P>0.05);AT组患者梗死核心体积小于CE组[8(1,34)ml vs.57(13,84)ml],差异有统计学意义(Z=-2.031,P<0.05),两组患者缺血半暗带体积与梗死核心体积的差值差异没有统计学意义[23(0,79)ml vs.19(1,33)ml,Z=-0.627,P<0.05]。结论:动脉粥样硬化血栓形成和心源性栓塞所致的急性脑梗死特征在多模态CT评估结果中有差异,该差异有助于鉴别这两种病因所致的急性脑梗死,对临床的病因诊断和治疗有一定指导意义。

Purpose:To explore the characteristics of acute cerebral infarction(ACI)caused by two common causes in multimodal CT.Methods:This retrospective study included 42 patients with ACI,of which,29 patients were caused by atherosclerotic thrombosis(AT)and 13 patients were caused by cardiogenic embolism(CE).The results of multimodal CT in the two groups(ACI patients caused by AT or CE)were compared and statistically analyzed.Results:The incidence of multi-segment embolus in AT group and CE group was 41.4% and 7.7%,the difference was with statistical significance(χ^(2)=4.766,P<0.05).The proportion of patients in AT group and CE group involved in middle cerebral artery was with no significant difference(χ^(2)=0.073,P>0.05).The regional leptomeningeal score in AT group was higher than that in CE group[18(16,19)vs 17(12,17)],and the difference was with statistical significance(Z=-2.201,P<0.05).The volume of ischemic penumbra in AT group was smaller than that in CE group[47(9,118)ml vs 73(35,99)ml],but there was with no significant difference between the two groups(Z=-0.872,P>0.05).The volume of infarct core in AT group was smaller than that in CE group[8(1,34)ml vs 57(13,84)ml],and the difference was with statistical significance(Z=-2.031,P<0.05).The volume difference of ischemic penumbra and infarct core was with no significant difference between the two groups[23(0,79)ml vs 19(1,33)ml,Z=-0.627,P>0.05].Conclusions:There are differences between the results of multimodal CT in patients with ACI caused by atherosclerotic thrombosis and cardiogenic embolism.The differences are helpful to distinguish the acute cerebral infarction caused by these two causes.It has certain guiding significance for etiological diagnosis and treatment.