大脑中动脉M1段闭塞后侧支循环状态与DWI-ASPECTS相关性研究

Study of collateral circulation status and diffusion-weighted imaging Alberta Stroke Program Early CT Score after middle cerebral artery M1 occlusion

目的探索大脑中动脉M1段闭塞后侧支循环状态与基于扩散加权成像(DWI)的Alberta卒中项目早期CT评分(DWI-ASPECTS)的相关性。方法回顾性分析52例大脑中动脉M1段闭塞患者临床及影像资料。侧支循环评估包括大脑前/后动脉偏侧优势(ACAL/PCAL)征象及T2-FLAIR高信号血管征(HVS)。使用DWI-ASPECTS进行定量分析脑梗死严重程度。结果52例患者中,ACAL阳性17例(32.7%),PCAL阳性18例(34.6%),HVS显著22例(42.3%),平均DWI-ASPECTS(5±2)分。ACAL与PCAL、ACAL与HVS显著、PCAL与HVS显著分别存在相关性,P值分别为P<0.001、P=0.004、P=0.010,Spearman相关系数分别为r=0.699、0.399、0.359。是否存在ACAL/PCAL征象,组间DWI-ASPECTS无统计学差异(P>0.05)。是否存在HVS显著,组间DWI-ASPECTS差异具有统计学意义(P=0.001),Spearman相关系数为r=0.415。结论大脑中动脉M1段闭塞患者通过观察常规磁共振检查序列评估ACAL、PCAL与HVS可反映侧支循环状态,有助于脑梗死程度评估。

Objective Correlation between the status of collateral circulation and diffusion-weighted imaging Alberta Stroke Program Early CT Score(DWI-ASPECTS)after occlusion of the middle cerebral artery(MCA)M1 remains to be investigated.Methods The clinical and imaging data of 52 patients with MCA M1 segment occlusion were retrospectively analyzed.The evaluation of collateral circulation includes anterior cerebral artery laterality/posterior cerebral artery laterality(ACAL/PCAL)and T2-FLAIR hypersignal vascular sign(HVS).DWI-ASPECTS provides a quantitative analysis of the severity of cerebral infarction.Results Among 52 patients,17(32.7%)were ACAL positive,18(34.6%)were PCAL positive.Additionally,significant HVS was observed in 22 patients(42.3%).The mean DWI-ASPECTS score was 5±2.There were significant correlations between ACAL and PCAL,ACAL and HVS prominence,as well as PCAL and HVS prominence with respective P values of<0.001,0.004,and 0.010.The Spearman correlation coefficients for these associations were r=0.699,0.399,and 0.359.There was no significant difference in DWI-ASPECTS between the presence and absence of ACAL/PCAL signs(P>0.05).However,there was a significant difference in DWI-ASPECTS according to HVS prominence(P=0.001),with a Spearman correlation coefficient of r=0.415.Conclusion The assessment of anterior cerebral artery leptomeningeal collateral,posterior cerebral artery leptomeningeal collateral,and hypoperfusion volume on conventional MRI sequences can provide insights into the status of collateral circulation and aid in evaluating the severity of cerebral infarction in patients with occlusion of the M1 segment of the middle cerebral artery(MCA).