脑梗死软脑膜侧支血管的磁敏感加权成像与临床对照研究

Clinical study of susceptibility-weighted imaging in monitoring leptomeningeal collaterals in ischemic stroke

关键词:  磁敏感加权成像  磁共振成像  脑梗死  软脑膜侧支血管

Key words:  [Key words] susceptibility-weighted imaging  magnetic resonance imaging  ischemia stroke  leptomeningeal collateral

摘要:

[摘要] 目的　分析脑梗死软脑膜侧支血管的磁敏感加权成像（susceptibility-weighted imaging, SWI）特点及其与临床的相关性。方法　选择66例经临床和影像确诊的脑梗死患者进行MR检查。其中急性期26例，亚急性期29例，稳定恢复期11例。所有患者均行常规T1WI、T2WI、FLAIR、DWI及SWI扫描，其中27例行MRA检查，36例行SWI随诊。分析常规MRI及SWI图像特点。观察脑梗死软脑膜侧支血管的显示及显示程度，得出相应临床NIHSS评分，并进行相关统计学分析。结果　有45例显示脑梗死软脑膜侧支血管的存在，占68%。其中急性期和亚急性期显示41例，稳定恢复期显示4例，不同时期的软脑膜侧支血管显示特点差异有显著性意义（P<0.05）。2级显示20例，显示程度与临床NIHSS评分改变呈正相关（r=0.673，P<0.01）。 结论　量化分析脑梗死软脑膜侧支血管的SWI特点，有助于判断脑梗死侧支循环建立的情况，对临床治疗及预后评价起到一定的指导作用。

Abstract:

[Abstract] Objective To analyze the features of susceptibility-weighted imaging (SWI) of leptomeningeal collaterals in ischemia stroke and its clinical correlation. Methods Totally 66 patients with clinically or radiologically proved cerebral infarction, including 26 acute, 29 subacute and 11 chronic cerebral infarction, were examined with MRI. All patients received conventional sequences including T1WI, T2WI, FLAIR, DWI and SWI. Twenty-seven patients underwent MRA, and 36 patients were followed by SWI. Features of routine MRI and SWI were studied. The presence of leptomeningeal collaterals around the infarction was observed. The correlation between the extent of the leptomeningeal collateral and the NIHSS score was analyzed. Results Leptomeningeal collateral was revealed by SWI in 45 out of 66 (68%) cerebral infarctions, including 41cases in acute and subacute cerebral infarction, and 4 cases in stable and chronic stage. The visualization of collateral vessels around the infarction in different stages has significant difference (P<0.05). Twenty cases showed degree 2 collaterals. There was a positive correlation between the degree of leptomeningeal collateral displayed in the SWI and the NIHSS scores (rs=0.673, P<0.01). Conclusion Quantitative analysis of SWI features of leptomeningeal collaterals in ischemic stroke can help determine the establishment of collateral circulation of cerebral infarction, guide the clinical treatment and evaluate the prognosis.