Percheron动脉梗塞的MR特征和临床分析  

An investigation on the MRI and clinical characteristics of the Percheron artery occlusion

作　　者：侯洁 段阳 孙玉 徐志华 马向宏 杨本强 HOU Jie DUAN Yang SUN Yu XU Zhihua MA Xianghong YANG Benqiang(Department of Radiology, the General Hospital of Shenyang of PLA, Shenyang 110016, China)

机构地区：[1]解放军沈阳总医院放射诊断科,沈阳110016 [2]锦州医科大学,解放军沈阳总医院研究生培养基地

出　　处：《功能与分子医学影像学（电子版）》2017年第1期1127-1132,共6页Functional and Molecular Medical Imaging(Electronic Edition)

基　　金：辽宁省自然科学基金计划项目(201602768)

摘　　要：目的总结分析Percheron动脉梗塞的MRI特征和临床特点。方法回顾性分析解放军沈阳总医院2013年3月~2016年3月间诊治的10000例脑梗塞患者的临床及影像资料,其中21例经临床及MRI(常规平扫、DWI和MRA)诊断为Percheron动脉梗塞,总结其影像及临床特点。结果 21例中,男18例,女3例,年龄54~72岁,均急性起病,伴不同程度意识障碍。MRI显示单纯双侧丘脑对称性梗塞者5例(23.8﹪,5/21),双侧丘脑梗塞,合并其他部位梗塞者16例(76.2﹪,16/21),其中3例单侧或双侧丘脑出血性梗塞。8例出现中脑"V字征"。MRA显示脑部动脉狭窄或闭塞:大脑中动脉11例,大脑后动脉10例,颈内动脉7例,椎基底动脉6例,1例右侧椎动脉变异,1例右侧胚胎型大脑后动脉,3例未见明显异常。经治疗后有神经功能障碍后遗症者17例(80.9﹪,17/21)。结论 Percheron动脉梗塞MR显示双侧丘脑对称性梗塞或存在多部位梗塞,中脑出现"V字征"。MRA可显示脑内相应血管狭窄或闭塞。临床上具有起病急,伴不同程度意识障碍,预后差,遗留神经功能障碍等特征。Objective To analyze and summarize the MRI and clinical characteristics of the percheron artery occlusion. Method The MR images and clinical diagnosis of 10000 cerebral infarction patients, from March 2013 to March 2016, were retrospectively analyzed. Among them 21 patients were diagnosed with the occlusion of percheron artery. The clinical findings and MRI features observed in these cases were summarized. Result All patients experienced an acute onset with different levels of consciousness disorder （18 Male, 3 Female, age from 54 to 72 years）. MRI showed that 5 patients had just bilateral paramedian thalamic infarction （23.8 %, 5/21 ）, 16 patients had alsoother lesions＇ infarction （ 76.2 %, 16/21 ）. Three of them had unilateral or bilateral hemorrhagic infarction. MRA showed intra cerebral artery stenosis and occlusion in middle cerebral artery in 11 cases, in posterior cerebral artery in 10 cases, in internal carotid artery in 7 cases, in basilar-vertebral artery in 6 cases. Meanwhile, vertebral artery variation was found in 1 case, and the right embryonic cerebral artery was found in 1 case. No vascular abnormalities were found in 3 cases. Midbrain ＂v sign＂ were found in 8 cases. After related treatment （80.9 %, 17/21 ）, 17 patients still had some neurological deficits. Conclusion Bilateral paramedian thalamic infarction and other lesions＇ infarction were found on MR images in all patients, the midbrain ＂V sign＂ were also found in some cases. MRA showed the corresponding intra cerebral artery stenosis and occlusion. These acute cases with various levels of consciousness disorder have poor prognosis, and often end up with neurological deficits after treatment.

关 键 词：磁共振 丘脑梗塞 弥散加权成像 Percheron 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]