节段性中重度基底动脉狭窄与后循环缺血性脑卒中的相关性研究  

Correlation between segmental moderate and severe basilar artery stenosis and posterior circulation ischemic infarction

作　　者：吴琼[1] 赵明[1] 赵荟[1] 张晶[1] 付旷[1] WU Qiong;ZHAO Ming;ZHAO Hui;ZHANG Jing;FU Kuang(Department of Magnetic Resonance Imaging, The Second Affiliated Hospital of Harbin MedicalUniversity Harbin 150081, China)

机构地区：[1]哈尔滨医科大学附属第二医院磁共振成像诊断科

出　　处：《哈尔滨医科大学学报》2019年第3期284-288,共5页Journal of Harbin Medical University

摘　　要：目的探讨基底动脉狭窄情况与后循环缺血性脑卒中事件之间的关系,寻找与基底动脉狭窄相关的缺血性脑卒中危险因素。方法将入组的50例接受高分辨率磁共振成像评价的基底动脉节段性中重度狭窄患者按照后循环供血区缺血性脑卒中情况及基底动脉狭窄的具体情况进行分组。通过统计学方法分析基底动脉狭窄的部位、长度、程度、管壁增厚模式以及基底动脉粥样硬化斑块信号强度特征与后循环缺血性脑卒中事件的发生及表现之间的相关性。结果后循环供血区无梗死灶的病例狭窄位置全部位于中段且狭窄长度均不大于全长的三分之一。中上段为节段性中重度基底动脉狭窄的好发位置。基底动脉狭窄长度、管壁增厚模式及基底动脉粥样硬化斑块信号强度与后循环供血区有无新发梗死灶之间的相关性具有统计学意义(P<0.010,P<0.005)。基底动脉狭窄管壁增厚模式及基底动脉粥样硬化斑块信号强度与后循环供血区梗死灶新旧情况之间的相关性具有统计学意义(P<0.005)。结论长范围及(或)同心性基底动脉狭窄及基底动脉高信号强度粥样硬化斑块是节段性中重度基底动脉狭窄患者后循环供血区缺血性脑卒中发生的危险因素。Objective To explore the relationship between basilar artery stenosis and posterior circulation ischemic infarction events, and to identify risk factors for cerebral infarction associated with basilar artery stenosis. Methods Fifty patients with segmental moderate to severe basilar artery stenosis evaluated by high resolution magnetic resonance imaging(HRMRI) were divided into two groups according to the cerebral infarction and basilar artery stenosis in the area of posterior circulation. The location, length, degree of basilar artery stenosis, thickening pattern of basilar artery wall, signal intensity characteristics of basilar atherosclerotic plaque and the occurrence and manifestation of posterior circulation ischemic infarction were analyzed statistically. Results The stenosis was located in the middle and the length of stenosis was not greater than one third of the total length in the patients without infarction in the posterior circulation blood supply area. The upper and middle segments were the prevalent locations of moderate and severe basilar artery stenosis. The correlation between the length of basilar artery stenosis, thickening pattern of vessel wall, signal intensity of basilar atherosclerotic plaque and the presence or absence of new infarcts in the posterior circulation blood supply area was statistically significant(P<0.010, P<0.005). The correlation between the thickening pattern of basilar artery stenosis wall and the signal intensity of basilar artery atherosclerotic plaque and the new or old infarction in the posterior circulation feeding area was statistically significant(P<0.005). Conclusion Long-range and/or concentric basilar artery stenosis and high-intensity atherosclerotic plaques are risk factors for ischemic infarction in the posterior circulation of patients with segmental moderate to severe basilar artery stenosis.

关 键 词：基底动脉狭窄 后循环 缺血性脑卒中 高分辨率磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]