伴心房颤动急性脑梗死DWI分型与神经功能缺损程度的关系分析  

Correlation study of DWI types and degree of neurologic impairment in acute ischemic stroke patients with atrial fibrillation

作　　者：贾晓涛[1] 田晔[1] 曲长君 杨军乐[2] 顾乃兵[1] 燕玉娥[1] 潘艳芳[3] 

机构地区：[1]西安交通大学附属西安市中心医院神经内科,陕西西安710003 [2]西安交通大学附属西安市中心医院影像科,陕西西安710003 [3]陕西中医药大学基础医学院病理教研室,陕西咸阳712046

出　　处：《实用放射学杂志》2017年第8期1167-1170,共4页Journal of Practical Radiology

基　　金：陕西省自然科学基础研究计划（2015JQ8299）.

摘　　要：目的 探讨伴心房颤动急性脑梗死扩散加权成像（DWI）分型和神经功能缺损程度的关系.方法 回顾性分析186例伴心房颤动急性脑梗死患者入院时早期DWI特征与其美国国立卫生研究院卒中量表（NIHSS）评分关系.结果 所有伴心房颤动急性脑梗死患者DWI均表现为高信号;其中前循环以单发皮层及皮层下梗死多见（94例,50.5%）,后循环以多发梗死多见（18例,13.0%）;左侧前循环皮层及皮层下梗死NIHSS评分（16.75±7.10）与右侧前循环皮层及皮层下梗死（13.50±5.70）差异有统计学意义（P〈0.05）;后循环多发梗死NIHSS评分（16.77±8.90）与较后循环皮层-皮层下梗死（6.38±2.03）差异有统计学意义（P〈0.05）.结论 伴心房颤动急性脑梗死DWI分型有助于脑梗死的病因诊断,结合NIHSS评分可以更好地评估疾病严重程度,为早期临床个体化治疗及预后判断提供依据.Objective To explore the correlations of diffusion-weighted imaging （DWI） types and the degree of neurologic impairment in acute ischemic stroke patients with atrial fibrillation.Methods DWI images and National Institutes of Health Stroke Scale（NIHSS） of 186 patients with acute ischemic stroke patients with atrial fibrillation were collected retrospectively.The correlation of DWI features and NIHSS was analyzed.Results On DWI,all acute ischemic stroke patients with atrial fibrillation presented high signal intensity.Single cortex-subcortical infarction mostly appeared in the anterior circulation（94,50.5%）;Multi-infarction commonly occurred in the posterior circulation（18,13.0%）;The neurological deficit scores of subcortical-cortex infarction in the left anterior circulation（16.75±7.10） were higher than that in the right side（13.50±5.70）（P〈0.05）.The neurological deficit scores of cortex-subcortical infarction in the posterior circulation （6.38±2.03） were significantly lower than that in the multi-infarction （16.77±8.90） （P〈0.05）.Conclusion DWI types are valuable for etiological diagnosis in ischemic stroke.Combination with NIHSS score could provide a basis for clinical individual treatment programs selection and prognostic evaluation.

关 键 词：心房颤动 心源性脑梗死 磁共振成像 

分 类 号：R541.75[医药卫生—心血管疾病] R743.33[医药卫生—内科学]