心房颤动引起心源性脑栓塞颅内梗死灶空间分布特点  

The Spatial Distribution Characteristics of Intracranial Infarct Lesions of Cardiogenic Cerebral Embolism Induced by Atrial Fibrillation

作　　者：叶祖森[1] 韩钊[1] 郑荣远[2] 李建策[3] 王贞[1] 臧秋玲[1] 王苹莉[1] 

机构地区：[1]温州医学院附属第一医院脑血管科 [2]温州医学院附属第一医院神经内科,325000 [3]温州医学院附属第一医院放射科,325000

出　　处：《中国临床神经科学》2009年第2期166-170,共5页Chinese Journal of Clinical Neurosciences

基　　金：温州市科技局(Y2004A014)

摘　　要：目的:探讨心房颤动引起心源性脑栓塞颅内梗死灶空间分布特点。方法:回顾性分析66例由心房颤动引起心源性脑栓塞患者早期弥散加权成像(DWI)的特征。结果:66例患者中有1例患者DWI上未见病灶,65例患者DWI上可见本次责任病灶。多发梗死灶患者有21/65例,占32.31%;双侧前循环供血区同时梗死7/21例,占多发脑梗死灶患者的33.33%;45例单独前循环供血区梗死患者中,左侧前循环供血区梗死23/45例(51.11%),右侧前循环供血区梗死15/45例(33.33%),脑栓塞以左侧居多;前循环供血区中大脑中动脉(MCA)供血区发生栓塞的概率最大(35/45例, 77.78%),35例大脑MCA供血区梗死患者中,皮质下梗死[9/35例(25.71%)]和皮质-皮质下梗死[22/35例(62.86%)]的患者例数明显多于皮质区梗死[4/35例(11.43%)]患者。结论:心房颤动引起心源性脑栓塞的脑内病灶左侧脑多见,大脑中动脉更易发生,皮质下和皮质-皮质下梗死多于皮质区梗死。Aim： To identify the spatial distribution characteristics of intracranial infarct lesions of cardiogenic cerebral embolism induced by atrial fibrillation. Methods： We analyzed the initial diffusion-weighted imaging （DWI） findings of 66 consecutive patients with cardiogenic cerebral embolism induced by atrial fibrillation. Results： Multiple lacunar stroke were detected in 21 of 65 patients （32.31%） with cardiogenic cerebral embolism induced by atrial fibrillation. Of the 21 patients there were 7 patients who were found to have multiple infarcts involving more than one artery territory of anterior circulation. Nearly half（23/45）of the patients were found to have single or multiple lesions in the left-unilateral anterior circulation, that was much more than the patients whose lesions were in the right-unilateral anterior circulation（15/45）. In the anterior circulation, lesions were showed more frequently in the middle cerebral artery（MCA） territory （35/45）. Corticosubcortical lesions （22/35） and subcortical lesions （9/35） were much more frequently than cortical lesions （4/35）. Conclusion： In patients with cardiogenic cerebral embolism induced by atrial fibrillation, the intracranial infarct lesions were showed more frequently in the left-unilateral anterior circulation, the MCA territory, subcortical lesion and corticosubcortical.

关 键 词：脑梗死 心源性脑栓塞 弥散加权成像 心房颤动 

分 类 号：R743[医药卫生—神经病学与精神病学]