摘要
目的利用磁敏感加权成像(SWI)技术显示大脑中动脉供血区急性缺血性卒中患者发生深部髓质静脉扩张情况,分析深部髓质静脉扩张的临床意义。方法搜集大脑中动脉供血区急性缺血性卒中患者42例,均于发病后48 h内完成头颅常规MRI、扩散加权成像(DWI)、SWI和磁共振血管成像(MRA)检查。入院时进行美国国立卫生研究院卒中量表(NIHSS)评分,由2名高年资神经放射组医师用盲法评估患者髓质静脉情况,分别采用Mann-Whitney U检验和Spearman相关分析评价髓质静脉扩张与脑梗死体积、入院时NIHSS评分的关系。结果 42例患者中,SWI观察到29例出现髓质静脉不对称扩张。2名医师对髓质静脉扩张评估结果的一致性较好(k=0.807,P<0.01)。髓质静脉扩张与脑梗死灶体积具有相关性(P=0.046);髓质静脉扩张分级越高者,NIHSS评分越高(r=0.468,P=0.002),患者临床症状越重。结论在大脑中动脉供血区急性缺血性脑卒中患者中,出现深部髓质静脉扩张提示患者脑梗死区侧支循环代偿不良,观察深部髓质静脉扩张可快速评估急性缺血性脑卒中的严重程度,有利于指导临床治疗及评估患者预后。
Objective To investigate the prominent deep medullary veins on susceptibility weighted imaging(SWI) in patients with acute ischemic stroke(AIS) in middle cerebral artery,and to analyze the clinical significance of the deep medullary vein dilatation. Methods Patients with acute ischemic stroke underwent routine MRI,diffusion-weighted imaging(DWI),SWI,MR angiography scan within 48 h following stroke onset. The National Institutes of Health Stroke Scale score(NIHSS) of patients at admission were evaluated,the deep medullary venous abnormality of all patients were independently graded by two experienced neuro-radiologists. Mann-Whitney U test and Spearman correlation analysis were used to evaluate the correlation among medullary venous dilatation,cerebral infarction volume,NIHSS score on admission. Results Among 42 patients,prominent medullary veins were found in 29 patients on SWI. There was perfect agreement(k=0.807,P<0.01) in the results of the medullary veins enlargement between two observers. Enlargement of medullary veins was related to the volume of cerebral infarction(P=0.046);The higher the medullary veins dilatation grade,the higher was the NIHSS score(r=0.468,P=0.002). Conclusion Deep medullary vein dilatation implied poor compensatory collateral circulation in patients with acute ischemic stroke in the middle cerebral artery. Observing prominent deep medullary veins,which are related to the severity of acute ischemic stroke,was helpful to guide clinical treatment and evaluate patients prognosis.
作者
杨粤龙
陈静勿
谢新凤
吴晓玲
黄飚
YANG Yuelong;CHEN Jingwu;XIE Xinfeng(The Second School of Clinical Medicine,Southern Medical University,Guangzhou 510515,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第11期2032-2036,共5页
Journal of Clinical Radiology
关键词
缺血性卒中
磁敏感加权成像
大脑中动脉
静脉
Ischemic stroke
Susceptibility weighted imaging
Middle cerebral artery
Veins
