多模态MRI联合CT评估大面积脑梗死相关脑皮质层状坏死的影像学特征及其临床意义  

Imaging features and clinical significance of multimodal MRI combined with CT in the evaluation of large hemispheric infarction with cortical laminar necrosis

作　　者：李兆勇 梁俊生 王青云 何银雀 李佳钰 林燕萍 李扬彬[2] LI Zhaoyong;LIANG Junsheng;WANG Qingyun;HE Yinque;LI Jiayu;LIN Yanping;LI Yangbin(Department of Radiology,Tung Wah Hospital Affiliated of Sun Yat-sen University,Dongguan 523013,China)

机构地区：[1]中山大学附属东华医院放射科,广东东莞523013 [2]广州医科大学附属第二医院放射科,广东广州510260

出　　处：《中国中西医结合影像学杂志》2021年第4期338-342,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨大面积脑梗死(LHI)相关脑皮质层状坏死(CLN)的影像学特点及其临床意义。方法:收集58例LHI相关CLN患者为研究组,同期收集76例LHI患者为对照组。总结CLN的多模态MRI及CT特点,比较2组临床资料及美国国立卫生研究院卒中量表(NIHSS)评分。结果:研究组表现为皮质特征性条带状异常信号/密度,T_(1)WI、T_(2) FLAIR、MRA原始图以高信号为主,DWI、ADC及SWI以等信号为主,CT以等/高密度为主。MRA示责任血管5例闭塞,37例重度狭窄,16例中度狭窄。多模态MRI的CLN检出率(94.8%)高于CT(32.8%)和常规MRI(79.3%),差异均有统计学意义(均P<0.05)。研究组出院时NIHSS评分高于对照组,差异有统计学意义(P<0.05)。结论:多模态MRI联合CT能够准确评估LHI相关CLN的影像学特征;CLN的出现提示预后不良,应引起影像科及临床医师的重视。Objective:To investigate the imaging features and clinical significance of large hemispheric infarction(LHI)with cortical laminar necrosis(CLN).Methods:Fifty-eight patients of LHI with CLN were collected as the study group,and 76 patients of LHI as the control group.The imaging features of CLN were summarized,and the clinical data and National Institutes of Health Stroke Scale(NIHSS)scores of patients in the two groups were compared.Results:The study group showed characteristic striped abnormal signal/density in cerebral cortex.CLN showed hyperintense on the original images of T_(1)WI,T_(2) FLAIR and MRA,hypointensity on DWI,ADC and SWI,equal/high density on CT.MRA showed that the responsible vessels were occluded in 5 cases,severely stenotic in 37 cases and moderately stenotic in 16 cases.The positive rate of CLN in multimodal MRI(94.8%)was significantly higher than that in CT(32.8%)and conventional MRI(79.3%)(both P<0.05).The NIHSS score of the study group at discharge was significantly higher than that of the control group(P<0.05).Conclusions:Multimodal MRI combined with CT can accurately evaluate the imaging characteristics of LHI with CLN.The presence of CLN indicates a poor prognosis,which should raise the awareness of radiologists and clinicians.

关 键 词：大脑梗塞 体层摄影术 X线计算机 磁共振成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学]