高血压脑微出血患者磁共振成像特征  

Observation on cerebral microbleeds in patients with hypertension by magnetic resonance imaging

作　　者：唐洲平[1] 刘菲[1] 张琳[2] 朱文珍[2] 曾和松[3] 朱遂强[1] 张苏明[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030 [2]华中科技大学同济医学院附属同济医院放射科,武汉430030 [3]华中科技大学同济医学院附属同济医院心内科,武汉430030

出　　处：《中华神经科杂志》2009年第1期53-55,共3页Chinese Journal of Neurology

基　　金：国家自然科学基金面上项目（30570628,30770751）

摘　　要：目的比较和分析高血压患者脑微出血（cerebral microbleed，CMB）的发生率、微出血的出血点数和好发位置及其相关因素。方法选择年龄在35～75岁的高血压患者，分为对照组、大动脉栓塞组和腔隙性脑梗死组。所有患者均行磁共振常规扫描以及磁敏感加权成像（susceptibility—weighted imaging，SWI）扫描。结果3组患者中均有CMB病灶阳性患者，总发生率33．8％，腔隙性脑梗死组（52．4％）及大动脉栓塞组CMB阳性率（38．1％）显著高于对照组（8．7％，Х^2=8．08，P〈0．01及Х^2=3．86，P〈0．05）。斑点状信号缺失病灶多分布于皮质-皮质下、双侧基底节区，其分布与脑实质梗死灶分布没有明显联系。结论高血压患者可在SWI上发现CMB病灶，可考虑将SWI作为筛选CMB病灶的常规检查和评价患者出血倾向的指标之一，为患者选择合适的治疗方案。Objective To concentrate on the morbidity of cerebral microbleed （CMB） in patients with hypertension and to analyze the predilection and risk-factor of cerebral microbleed. Method Hypertensive patients were divided into the simple hypertention group, hypertention group with lacunar infarction and hypertention group with cerebral infarction. All of these 65 patients received examination of susceptibility-weighted imaging. Results Ninety-one focuses of cerebral microblecds were found in these patients：58.2% of these focuses were in both basal ganglia and cerebral ganglion;35.2 percent were in cortex and subcortex ;6. 6 percent were in brainstem and cerebellum. The total morbidity of CMB was 33.8 percent, 52.4 percent in the group with lacunar infarction and 38.1 percent in the group with cerebral infarction, both were significantly higher than that of 8.7 percent in the simple hypertensive group （Х^2 = 8.08,P 〈 0.01 and. Х^2= 3.86, P 〈 0.05 ）. Conclusions The focus of CMB suggested the hemorrhagic tendency in endocranial capillary. CMB can be used as a routine exam for the hemorrhagic tendency in endocranial capillary. Synthetic analysis of risk-factor and the result of SWI help clinicians choose suitable treatment for each patient.

关 键 词：颅内出血 高血压性 脑梗死 磁共振成像 

分 类 号：R686[医药卫生—骨科学]