37例致缺血性脑卒中脑动脉夹层临床和影像学特征分析  

Clinical and Imaging Features of 37 Patients with Ischemic Stroke and Cerebral Artery Dissection

作　　者：林强[1] 赖海辉[1] Lin Qiang;Lai Haihui(Radiological Department, Huizhou First People's Hospital, Huizhou 516000, Guangdong Province, China)

机构地区：[1]惠州市第一人民医院放射科,惠州市516000

出　　处：《中国病案》2018年第12期102-104,共3页Chinese Medical Record

摘　　要：目的分析致缺血性脑卒中脑动脉夹层的临床特点和影像学特征,并总结引发疾病发生的机制。方法选择某院自2015年1月-2018年6月收治的37例致缺血性脑卒中脑动脉夹层患者作为研究对象,对患者的临床特点和影像学特征进行回顾性分析。结果颅内脑动脉夹层17例,颅外脑动脉夹层20例,颅内组和颅外组患者的夹层影像学表现、缺血性脑卒中发病机制对比均无显著差异(P>0.05),颅外组患者栓塞率明显高于颅内组,两组对比,P<0.05,差异具有统计学意义。抗凝治疗后,所有患者的mRS评分明显低于治疗前,治疗前后对比,P<0.05,差异具有统计学意义。结论致缺血性脑卒中脑动脉夹层可分为颅内脑动脉夹层和颅外脑动脉夹层,两种脑动脉夹层的影像学特征均以动脉瘤夹层为主,患者夹层穿支闭塞、栓塞+血流动力学及栓塞+穿支闭塞是引发其出现缺血性脑卒中的相关机制,且夹层栓塞是引发颅外脑动脉夹层患者出现致缺血性脑卒中的主要机制。Objective To analyze the clinical features and imaging characteristics of cerebral artery dissection(CAD) induced by ischemic stroke and to summarize the mechanism of the disease.Methods Thirty-seven patients with ischemic stroke with cerebral artery dissection admitted to our hospital from January 2015 to June 2018 were selected as the research object.The clinical features and imaging features of the patients were retrospectively analyzed.Results 17 cases of intracranial CAD,20 cases of extracranial CAD,intracranial group and extracranial group showed no significant difference in the imaging findings and pathogenesis of ischemic stroke(P>0.05).The embolization rate was significantly higher in the group than in the intracranial group,and the difference between the two groups was significant(P<0.05).After targeted anticoagulant therapy,the mRS scores of all patients were significantly lower than before treatment,and the difference was significant before and after treatment(P<0.05).Conclusion The CAD of ischemic stroke can be divided into intracranial CAD and extracranial CAD.The features of the two CAD images are mainly aneurysm,occlusion,occlusion,hemodynamics and embolism+wear branch occlusion is the underlying mechanism that triggers ischemic stroke,and mesentery embolization is the primary mechanism of ischemic stroke in patients with extracranial CAD.

关 键 词：缺血性脑卒中 脑动脉夹层 临床特点 影像学特征 分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]