大脑中动脉高密度征的动态螺旋CT表现及其对超急性期脑梗死的诊断及预后判断价值  

The Dynamic Changes of Computerized Tomography (CT) Manifestations and Clinical Value of Hyperdense Middle Cerebral Artery Sign ( HMCAS ) in Hyperacute infarction

作　　者：白青科[1] 赵振国[1] 隋海晶[1] 王锦文[1] 汪勤勇[1] 严正言[1] 李跃华[1] 龚怡[1] 

机构地区：[1]上海市浦东新区人民医院,上海市201200

出　　处：《中国卒中杂志》2006年第7期478-480,共3页Chinese Journal of Stroke

摘　　要：目的探讨大脑中动脉高密度征(hyperdense middle cerebral artery sign,HMCAS)在大脑中动脉(Middle cerebral artery,MCA)供血区超急性期梗死的诊断价值及动态CT表现的临床意义。方法对46例MCA供血区超急性期脑梗死(发病6h内)MCA的CT征象及临床表现进行分析,并定期复查CT观察其动态变化。结果MCA供血区超急性期脑梗死46例中表现为HMCAS者32例(69.6%),临床均为完全前循环梗死,25例死亡(78.1%),其中HMCAS进展且合并MCA点状征(MCA dot sign)的14例中12例(85.7%)死亡,其余均遗留严重神经功能缺损;而无HMCAS的14例中8例为部分前循环梗死,6例为完全前循环梗死,仅2例(14.3%)死亡。有HMCAS的患者死亡的发生率明显大于无HMCAS的患者(P<0.01)。经随访,3例患者HMCAS消失,病人病情好转且均转化为出血性脑梗死。结论HMCAS的动态CT变化有助于大脑中动脉供血区超急性期脑梗死的诊断及预后判断。Objective To investigate the diagnostic value of HMCAS and clinical significance of the dynamic changes of CT manifestations in hyperacute infarction. Methods Clinical characteristics and CT findings were analyzed in 46 cases with hyperacute middle cerebral artery (MCA)infarction within 6 hours. CT scan was made periodically as followed- up examination to observe its dynamic changes. Results HMCAS was observed in 32 cases of all 46 patients with total anterior circulation infarct (TACI) and in which 25 cases died. Twelve cases died in 14 cases of HMCAS progressed and dot sign appeared. The rest two cases remained severe defect of nerve function. OF the 14 cases without HMCAS, 8 cases were partial anterior circulation infarction (PACI), 6 cases were TACI and only 2 cases died. The difference of frequency of died patients with or without HMCAS had statistical significance (P<0.01). HMCAS disappeared in 3 cases at followed-up CT scan and these cases transformed into hemorrhage infarction but their condition turned better. Conclusion The dynamic changes of CT scan of HMCAS will help diagnosis in hyperacute MCA infarction and assessment of prognosis .

关 键 词：大脑中动脉高密度征 脑梗死 计算机体层摄影术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]