单侧MCA慢性闭塞患者FVH变化规律及其对脑梗死的预测作用  

The changing regular patterns of FLAIR vascular hyperintensity in patients with chronic unilateral middle cerebral artery occlusion and its predictive effect on cerebral infarction

作　　者：师强 杨增烨[1] 郑莹莹[1] 师宁[1] SHI Qiang;YANG Zengye;ZHENG Yingying;SHI Ning(The Affiliated Hospital of Yan′an University,Yan′an 716000,Shanxi,China)

机构地区：[1]延安大学附属医院,陕西延安716000

出　　处：《西部医学》2023年第10期1537-1540,1544,共5页Medical Journal of West China

基　　金：延安市科学技术研究发展计划项目(2016KS-03)。

摘　　要：目的探讨单侧大脑中动脉(MCA)慢性闭塞患者MRI液体衰减反转恢复序列高信号血管征(FVH)的变化规律及其对脑梗死的预测作用。方法选取我院2019年1月-2021年1月收治的121例单侧MCA慢性闭塞患者,行回顾性分析,按有无FVH分为FVH组(36例)和非FVH组(85例)。统计分析两组临床资料数据并采用受试者工作特征(ROC)曲线分析FVH对脑梗死的预测作用。结果FVH组脑梗死发生率显著高于非FVH组,差异有统计意义(χ^(2)=4.130,P=0.042),两组性别、年龄、BMI等一般资料相比差异无统计意义(P>0.05)。121例单侧MCA慢性闭塞患者,发生脑梗死80例,占比66.12%。脑梗死者阿尔伯塔卒中项目早期CT评分(ASPECTs)显著高于非脑梗死者,差异有统计意义(t=10.291,P<0.001)。ROC曲线分析显示,FVH的ASPECTs评分预测单侧MCA慢性闭塞患者脑梗死的AUC为0.847(P<0.01)。结论FVH出现提示单侧MCA慢性闭塞患者脑血流灌注发生异常进展,脑梗死发生风险升高,其ASPECTs评分对患者发生脑梗死具有中等预测价值。Objective To investigate the changes of MRI fluid-attenuated inversion recovery vascular hyperintensity(FVH)in patients with unilateral middle cerebral artery(MCA)chronic occlusion and its predictive effect on cerebral infarction.Methods A total of 121 patients with unilateral MCA chronic occlusion admitted to our hospital from January 2019 to January 2021 were used as the retrospective cohort study subjects.They were divided into two groups according to the presence or absence of FVH,36 cases in the FVH group and 85 cases in the non-FVH group.The clinical data of the two groups were statistically analyzed and the receiver operating characteristic(ROC)curve was used to analyze the predictive effect of FVH on cerebral infarction.Results The incidence of cerebral infarction in FVH group(97.22%)was significantly higher than that in non FVH group(52.94%)(χ^(2)=4.130,P=0.0042),but there was no significant difference between them in basic clinical data such as gender,age and BMI(P>0.05).Among the 121 patients with unilateral MCA chronic occlusion,80 had cerebral infarction,accounting for 66.12%.The ASPECTs score of cerebral infarction patients was(3.13±0.75),and ASPECTs score of non-cerebral infarction patients was(1.68±0.70),and the difference was statistically significant(t=10.291,P<0.001).ROC curve analysis showed that the ASPECTs score of FVH predicted the AUC of cerebral infarction in patients with unilateral MCA chronic occlusion was 0.847(P<0.01).Conclusion The occurrence of FVH indicates abnormal progression of cerebral blood perfusion in patients with unilateral MCA chronic occlusion,and the risk of cerebral infarction increases.Its ASPECTs scores have moderate predictive value for patients with cerebral infarction.

关 键 词：脑梗死 慢性闭塞 大脑中动脉 单侧 液体衰减反转恢复序列高信号血管征 

分 类 号：R743[医药卫生—神经病学与精神病学]