后循环梗死的临床表现与磁共振成像的关系  

The correlation between the clinical manifestation and MRI in patients with posterior circulation infarct

作　　者：龚涛[1] 陈海波[1] 

机构地区：[1]卫生部北京医院神经内科,100730

出　　处：《中国脑血管病杂志》2005年第7期303-306,310,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：首都医学发展科研基金(2002-2022)

摘　　要：目的探讨后循环梗死(POCI)的临床表现与磁共振成像(MRI)的关系。方法对117例经MRI证实的POCI患者的临床资料进行回顾性研究,根据临床表现将患者分为单病灶临床表现、多病灶临床表现和不能定位临床表现;根据MRI的检查结果,将POCI病灶分为单病灶病变、多病灶病变。结合MRI检查,分析POCI患者的临床表现,了解POCI的临床特点。结果117例患者中,有27例临床明确诊断为单一病灶。其中临床诊断为枕叶病变者8例,MRI结果显示枕叶病变者6例;小脑6例,MRI证实者4例;中脑1例,延髓7例,脑桥5例,病灶在后3个部位的临床诊断与MRI的结果完全相符。117例患者中,临床诊断为多病灶病变者38例,其中36例MRI显示为多病灶。117例患者中,24例伴有嗜睡或昏迷等意识障碍的临床表现,MRI显示其中22例为多病灶。结论POCI的临床表现复杂多样,但特征性的临床表现对诊断POCI的帮助较大。与枕叶、丘脑及小脑相比,中脑、脑桥及延髓局部损伤的临床表现与MRI的检查结果相符性更好。Objective To analysis the correlation between the clinical manifestation and MRI on patients with posterior circulation infarct(POCI). Methods To study all clinical information of 117 patients with POCI proved by MRI retrospectively. All patients were divided into three groups according to their clinical manifestations, that was clinical single focus group, clinical multiple foci group and unlocalizable group, and then according to the results of MRI detection, the patients were divided into pathological single focus group and pathological multiple foci group. Based on the results of MRI detection, the clinical manifestation of the patients with POCI were analyzed. Results 27 of 117 patients were diagnosed clinically as single focus, 8 of them were localiged clinically as occipital lobe lesion and confirmed by MRI in 6 patients, 6 of them as cerebellar lesion and confirmed in 4 patients. The other 13 patients were diagnosed clinically as mesencephalonic lesson in 1, pontine in 5, and oblongata medullary in 7 patients, all of them were confirmed by MRI detection. 38 of 117 patients were diagnosed clinically as multiple foci. MRI confirmed in 36 patients. 24 of 117 patients presented with somnolence or coma, MRI showed pathological change of multiple foci in 22 patients. Conclusion The clinical manifestations in patients with POCI are complicate, but the characteristic presentation is helpful for diagnosis. The clinical pictures of mesencephalon, pons and oblongata medulla lesions correspond to the results of MRI detection are better than those of occipital lobe, thalamus and cerebellum.

关 键 词：临床表现 磁共振成像 后循环梗死 临床诊断 检查结果 枕叶病变 回顾性研究 多病灶 MRI检查 临床资料 临床特点 意识障碍 局部损伤 患者 显示 特征性 相符性 小脑 中脑 延髓 脑桥 

分 类 号：R743.3[医药卫生—神经病学与精神病学]