磁敏感加权成像毛刷征与急性缺血性卒中患者血管反应性的关系  

Relationship between brash sign on susceptibility-weighted imaging and cerebrovascular reactivity in patients with acute ischemic Stroke

作　　者：韩献军[1] 黄红莉[1] 单树崇 

机构地区：[1]徐州市第一人民医院神经内科,221002

出　　处：《国际脑血管病杂志》2014年第2期99-104,共6页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨大脑中动脉（middlecerebralartery，MCA）供血区急性脑梗死患者磁敏感加权成像（susceptNility—weightedimaging，SWI）显示的患侧侧脑室旁深部髓质静脉（deepmedullaryvein，DMV）数量与同侧颈内动脉（internalcarotidartery，ICA）系统大动脉狭窄程度和脑血管反应性（cerebrovascularreactivity，CVR）的关系。方法回顾性纳入在住院期间接受SWI、脑血管造影以及经颅多普勒CO，激发试验的MCA供血区急性脑梗死患者，根据SWI图像中可辨别的侧脑室旁DMV数量分为3级：1级，〈5条；2级：5～10条；3级：〉10条。分析DMV分级与同侧ICA／MCA狭窄程度和CVR的相关性。结果共纳入MCA供血区急性脑梗死患者44例，DMV1级24例，2级15例，3级5例，患侧ICA系统主干动脉平均狭窄程度为（40．52±30．62）％，MCA平均CVR为0．41±0．16。DMV1级、2级和3级组血管狭窄程度分别为（31．31±26．02）％、（44．93±31．03）％和（71．76±26．68）％，3组间存在显著性差异（F=4．589，P=0．018），且DMV3级组显著性高于DMV1级组（P=0．014）。DMV1级、2级和3级组CVR分别为（0．45±0．12）、（0．41±0．18）和（0．22±0．12），3组间存在显著性差异（F=6．179，P=0．005），且DMV3级组显著性低于DMV1级组（P=0．006）和DMV2级组（P=0．038）。Spearman相关分析显示，DMV分级与血管狭窄程度呈显著正相关（rs-=0．381，P=0．013），与CVR呈显著负相关（rs=-0．375，P=0．012）。结论脑梗死患者DMV分级与责任大动脉狭窄程度呈正相关联系，与责任侧MCACVR呈负相关。Objective To investigate the relationship between the numbers of deep medullary veins （DMV） beside the ipsilateral lateral ventricle and the stenotic degree of large artery of ipsilateral internal carotid artery （ICA） system and cerebrovascular reactivity （CVR） in patients with acute cerebral infarction showed on susceptNility-weighted imaging （SWI） in middle cerebral artery （MCA） territory. Methods The patients with acute cerebral infarction in MCA territory who underwent SWI, cerebral angiography and the transcranial Doppler carbon dioxide challenge test during the hospital stay were enrolled retrospectively. According to the numbers of DMV beside the lateral ventricle on SWI, they were classified into 3 grades： Grade 1： DMV 〈5; Grade 2： DMV 5 - 10; Grade 3： DMV 〉 10. The correlations of the DMV grades and the degree of ipsilateral ICA/MCA and CVR were analyzed. Results A total of 44 patients with acute cerebral infarction in MCA territory were enrolled. Twenty-four patients were DMV 1, 15 were DMV2, and 5 were DMV 3. The mean stenosis degree of the main arteries of the ipsilateral ICA system was 40. 52% ± 30.62%. The mean CVR of MCA was 0.41 ±0. 16. The stenosis degrees in the DMA grade 1, 2, and 3 groups were 31.31% e 26.02%, 44. 93% e 31.03%, and 71.76% ± 26.68%, respectively. There were significant differences among the 3 groups （F = 4. 589, P = 0. 018）, and the stenosis degree in the DMVgrade 3 group was significantly higher than that in the DMV grade 1 group （P =0. 014）. The CVRs in the grade 1, 2, and 3 groups were 0. 45 ± 0. 12, 0. 41 ± 0. 18, and 0. 22 ＋ 0. 12, respectively. There were significant differences among the 3 groups （F =6. 179, P =0. 005）, and the CVR in the DMV grade 3 group was significantly lower than that in the DMV grade 1 group （P = 0. 006） and in the DMV grade 2 group （P = 0. 038）. Spearman correlation analysis showed that DMV grade was significantly positively correlated with the stenosis degree （r =0. 381, P =0. 013）, a

关 键 词：卒中 脑缺血 颈动脉狭窄 颅内动脉硬化 脑静脉 大脑中动脉 磁共振成像 超声检查 多普勒 经颅 

分 类 号：R743.3[医药卫生—神经病学与精神病学]