交界区脑梗死与脑动脉狭窄或闭塞的关系

The relationship between cerebral border zone infarction and cerebral artery stenosis or occlusion

目的 观察交界区脑梗死与颅内外主要动脉狭窄或闭塞的关系。方法 回顾性分析经磁共振(MRI)弥散加权成像 (DWI)检查证实的急性交界区脑梗死 4 5例患者的临床资料 ,将交界区梗死部位分为前交界区、后交界区及内交界区 ,利用磁共振血管成像 (MRA)和经颅超声多普勒 (TCD)检查判断颅内外主要动脉有无狭窄或闭塞 ,观察梗死部位与血管受累的情况。结果 4 5例中共有 32例 (71 1% )存在相应血管狭窄或闭塞。大脑中动脉狭窄出现比例最高 (4 7 6 % ) ,其次为颈内动脉狭窄或闭塞 (31% ) ,大脑前或后动脉狭窄少(11 9% )。动脉异常情况在单交界区与多交界区梗死的患者间无差别 ,但内交界区受累更易合并大脑中动脉狭窄 (P <0 0 5 )。结论 交界区脑梗死患者常存在颅内外主要动脉狭窄或闭塞 ,大脑中动脉狭窄最常见 ,尤其在内交界区受累时。

Objective To observe the relationship between cerebral border zone infarction and cerebral artery stenosis or occlusion.Methods 45 patients admitted to our hospital in 2002 were studied retrospectively.They were diagnosied as acute cerebral border zone infarction and classified into anterior border infartion,posterior border infartion and internal border infartion by diffusion weighted MR imaging(DWI). The stenosis or occlusion of cerebral arteries was evaluated by magnetic resonance angiography(MRA) or transcranial doppler(TCD) examinations.Results Cerebral artery stenosis or occlusion was founded in 32 patients(71.1%).The lesions were most located in middle cerebral artery(47.6%),next in internal carotid artery(31%), relatively seldom in anterior cerebral artery and posterior cerebral artery(11.9%). No difference of artery abnormity was found between the patients with single border infarction and the patients with mutiple border infarction.But middle cerebral artery stenosis was more frequently seen in the patients with internal border infartion( P< 0.05).Conclusion Main cerebral artery stenosis or occlusion is common in patients with cerebral border zone infarction. Among patients with internal border zone infarction, middle cerebral artery stenosis was more frequently observed.