急性前循环脑梗死患者MR弥散成像分型与临床严重性分型的相关性  

The related research on MR diffusion weighted imaging classification and clinical subtype of acute anterior circulation infarcts

作　　者：王永安[1] 刘灶松[1] 黄立安[2] 王秀河[1] 罗良平[1] 

机构地区：[1]暨南大学附属第一医院放射科,广东广州510630 [2]暨南大学附属第一医院放射科神经内科

出　　处：《中国老年学杂志》2010年第7期873-875,共3页Chinese Journal of Gerontology

基　　金：国家自然科学基金小额资助(No.30772303);广东省医学科学技术研究基金资助(No.A2007332)

摘　　要：目的分析老年人急性前循环脑梗死MR弥散加权成像(DWI)梗死面积大小分型评分与临床症状严重性分型评分的相关性、一致性以及与MR血管成像血管狭窄程度分级评分的相关性。方法168例60岁以上急诊颅脑MR检查患者,行常规MRI序列、DWI、3D-TOF法MRA检查,临床严重性分类:完全性前循环梗死、部分前循环梗死、腔隙性梗死,MRDWI梗死面积大小分三型,MRA血管狭窄程度分三级,采用χ2检验。结果168例患者DWI全部出现异常高信号,MRA表现为血管迂曲硬化、狭窄、闭塞,MRDWI梗死面积大小分型评分与临床症状严重性分型评分呈强正相关(r=0.847,P=0.000)、一致性(Kappa值=0.654,P<0.0005),MRDWI梗死面积大小分型评分与同侧MRA大脑中动脉狭窄程度分级评分呈正相关(r=0.335,P=0.000),老年不同年龄组急性脑梗死MRDWI梗死面积大小分型构成比存在差异性(χ2=29.079,P<0.0005)。结论老年人急性前循环梗死MRDWI梗死面积与临床症状严重性呈强正相关及一致性,与MRA前循环大血管狭窄程度呈正相关,急性大面积梗死随年龄增加发病率有减少趋势。Objective To analyze the correlation and consistency of score among the lesion size classification on MR diffusion weighted imaging （DWI） and the clinical severity subtype and the degree of vascular stenosis in MRA on the elderly patients with acute anterior circulation cerebral infarction. Methods 168 elderly patients over 60 years old with emergency Head MR examination underwent conventional MRI sequences, FLair, DWI, 3D-TOF MRA imaging. The subtypes of clinical severity： total anterior circulation infarcts, partial anterior circulation infarcts and lacunar infarcts. There were three classifications of the lesion size on MR DWI. The degree of vascular stenosis on MRA was classified in three levels, statistical analysis using X2 test. Results All of 168 patients appeared abnormally high signal on DWI, with vessels appeared curve, sclerosis, stenosis and occlusion on MRA imaging. The score of lesion size classification on MR DWI was strongly positively correlated to the score of clinical severity subtype （r=0.847, P= 0.000） and they have consistency （P〈0.000 5）. And it was also positively associated with the stenosis degree of ipsilateral middle cerebral artery on MRA （r =0.335, P=0.000）. There was variability between constituent ratios of lesion size classification on MR DWI in different age groups of elderly patients with acute infarct （χ^2=29.079, P〈0.000 5）. Conclusions Lesion size on MR DWI shows strongly positive correlation and consistency with severity of clinical symptoms, and it is positively correlated to the stenosis degree of anterior circulation great vessels in elderly patients with acute anterior circulation infarct. With increasing age, there is decreasing trend in acute large area infarcts.

关 键 词：老龄 脑缺血 核磁共振 弥散加权成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]