FLAIR血管高信号征对颈动脉或大脑中动脉闭塞患者梗死形态的评估  

FLAIR vascular hyperintensity and lesion infarct morphology in carotid artery or middle cerebral artery occlusion

作　　者：张卫[1] 朱幼玲[1] 朱双根[1] 翟登月[1] 张文[1] 

机构地区：[1]安徽医科大学第三附属医院(合肥市第一人民医院)神经内科,合肥230061

出　　处：《安徽医科大学学报》2014年第3期381-384,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省教育厅合肥地区数字化脑卒中注册研究(编号:KJ2013Z119);合肥市第三周期医学重点学科[编号:2010(科)-09];校科学研究资助项目(编号:2013xkj048)

摘　　要：目的探讨FLAIR血管高信号征(FVH)对颈动脉或大脑中动脉闭塞患者梗死形态的评估价值。方法收集颈动脉或大脑中动脉闭塞患者共102例,均完成磁共振DWI、FLAIR序列,以及颈部或头颅MRA。采用Olindo方法对FVH进行评分,并分为FVH<4(包括FVH=0)和FVH≥4两组;根据FVH的部位不同分为远端FVH和无远端FVH两组;分别比较各组间梗死形态的差异。结果 102例患者中FVH<4者40例(39.2%),FVH≥4者62例(60.8%);两组在年龄、性别、高血压、糖尿病、高脂血症、吸烟史、血管闭塞部位差异无统计学意义(P>0.05),但梗死形态差异有统计学意义(P<0.01)。远端FVH者最常见穿动脉梗死及分水岭梗死,而无远端FVH者最常见大面积梗死;两组间差异有统计学意义(P<0.01)。结论不同数量、不同部位FVH对颈动脉或大脑中动脉闭塞患者梗死形态具有一定的预测价值。Objective To evaluate the association of FVH with infarct morphology in patients with symptomatic in-ternal carotid artery （ ICA） or middle cerebral artery （ MCA） occlusion. Methods MR images of 102 consecutive patients with acute stroke due to symptomatic ICA or MCA occlusion were reviewed. Vessel occlusions were identi-fied by MRA time of flight or contrast-enhanced MR angiography. Diffusion deficit volumes and infarct morphology on admission were assessed. The presence and number of FVH were evaluated according to Olindo’s method, and associations with MR morphology of infarction, as well as with stroke etiology were analyzed. Results The patients of FVH≥4 were 62（60.8%） of the 102 enrolled patients. Compared with the patients of FVH〈4,the former were significantly associated with infarct morphology（P〈0.01）. The patients with distal FVH were most common perfo-rator and border-zone infarcts, and the patients without distal FVH were most common large territorial infarcts. There was statistical significance between the two groups （ P〈0.01 ） . Conclusion The numbers and locations of FVH may be a predictive imaging marker for cerebral infarct morphology in symptomatic ICA or MCA occlusion.

关 键 词：FLAIR血管高信号征 颈动脉或大脑中动脉闭塞 梗死形态 

分 类 号：R743.33[医药卫生—神经病学与精神病学]