慢性进展性大脑中动脉主干闭塞的神经影像和脑血流  

Neuroimage and Cerebral Blood Flow in Patients with Chronic Progressive Occlusion of Middle Cerebral Artery Stem

作　　者：张雄伟[1] 张以善[1] 李晓华 王翠玉[1] 李曼[1] 李秋俐[1] 金文静[3] 

机构地区：[1]中国人民解放军第二炮兵总医院神经内科,北京市100088 [2]齐齐哈尔市肿瘤医院神经内科,黑龙江省齐齐哈尔市161002 [3]中国人民解放军第535医院神经内科,湖南省怀化市418008

出　　处：《中国动脉硬化杂志》2007年第4期296-298,共3页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨慢性进展性大脑中动脉主干闭塞患者的临床、神经影像和脑血流动力学改变。方法对75例大脑中动脉主干闭塞患者行头颅核磁共振成像、CT和经颅多普勒超声检测。结果65例(86.7%)出现脑缺血症状及体征。70例(93.3%)头颅核磁共振或CT显示不同类型脑梗死,最常见的是低灌注分水岭梗死和腔隙性脑梗死。60例(80.0%)闭塞侧大脑中动脉深度范围血流速度明显降低,70例(93.3%)闭塞侧大脑前动脉血流速度代偿性增快,45例(60.0%)闭塞侧大脑后动脉血流速度代偿性增快。结论经颅多普勒超声和神经影像学检查有助于评估慢性进展性大脑中动脉主干闭塞患者的病情发展和预后,为了解颅内侧支循环代偿状况和更深入研究缺血性脑血管病的发病机制提供客观依据。Aim To explore the clinic, neuroimage and eerebrovascular hemodynamics changes in patients with chronic progressive occlusion of middle cerebral artery stem. Methods Seventy five patients with middle cerebral artery stem occlusion were measured by MRI, CT and transcranial Doppler. Results Sixty five patients （86.7 % ）presented cerebral ischemic symptom and sign. Seventy patients （93.3% ） showed different cerebral infarction in MRI or CT. The hypoperfusion watershed infarct and lacunar infarct were most common. The blood flow velocity of occlusion side middle cerebral artery sample depth remarkably reduced in 60 patients （80.0%）. Seventy patients （93.3%）showed blood flow velocity compensative acceleration of the occlusion side anterior cerebral artery. Forty five patients （60.0% ） showed blood flow velocity compensative acceleration of the occlusion side posterior cerebral artery. Conclusions For patients with chronic progressive occlusion of middle cerebral artery stem, transcranial Doppler and nettroimage might help to evaluate the patient＇ condition and prognosis, they might be important and objective index in understanding the compensative state of collateral circulation and in studying deeply the pathologic mechanism of ischemie cerebrovascular disease.

关 键 词：神经病学 动脉闭塞 经颅多普勒 神经影像 脑血流 侧支循环 

分 类 号：R741[医药卫生—神经病学与精神病学]