缺血性脑卒中磁共振弥散加权成像表现与其病因的关系

摘要

Objective To study the relation between magnetic resonnance diffusion-weighted ima-ging(DWI) and etiology of ischemic stroke (IS). Methods Two hundred and six IS patients admitted to our hospital from January 2010 to September 2010 were divided into single IS group(n = 130) and multiple IS group(n = 76). After DWI,the TOAST of patients was classified according to their magnetic resonance DWI data and laboratory findings. Relation between their magnetic resonance DWI data and laboratory findings was analyzed. Results The DWI was related with the TOAST classification in IS patients(P = 0. 000). The cortical and subcortical infarction, anterior circulation unilateral multiple infarction and posterior circulation multiple infarction accounted for 60. 9%, 54. 3%, and 75. 0% respectively, which were mainly related with the conducting arthro-sclerosis(P = 0. 021,P = 0. 034,P = 0. 011). The small penetrating branch infarction(94. 0%) was mainly related with the small artery occlusion(P = 0. 000). In addition,certain cortical and subcortical infarction (26. 1%), anterior circulation bilateral multiple infarction (26. 7%), anterior and posterior circulation multiple infarction(28. 6%) were related with the cardiogenic embolism(P = 0. 008,P=0. 030, P = 0. 024). Certain small penetrating branch infarction (6. 0%) was related with the conducting arthroslerosis(P = 0. 000) ,and certain anterior circulation unilateral multiple infarction(17. 1%) was related with the small artery occlusion(P = 0. 007). Conclusion Early magnetic resonance DWI can predict the etiology of IS and provide useful information for the diagnosis and treatment of IS.%目的 探讨缺血性脑卒中患者的磁共振弥散加权成像(DWI)表现与病因学的相关性.方法 选择缺血性脑卒中患者206例,分为单发梗死组130例和多发梗死组76例.行头颅DWI检查后,根据其影像学表现、临床资料、实验室常规检查结果行TOAST分型,并分析两者的相关性.结果 缺血性脑卒中患者DWI表现与TOAST分型存在相关性(P-0.000),其中皮质-皮质下梗死(60.9％)、前循环单侧多发梗死(54.3％)和后循环多发梗死(75.0％)主要与大动脉粥样硬化型有关(P=0.021,P-0.034,P=0.011);小的穿通支梗死(94.0％)主要与小动脉闭塞型有关(P-0.000).此外,还有部分皮质-皮质下梗死(26.1％)、前循环双侧多发梗死(26.7％)和前后循环多发梗死(28.6％)与心源性栓塞型有关(P=0.008,P=0.030,P=0.024),部分小的穿通支梗死(6.0％)与大动脉粥样硬化型有关(P=0.000),部分前循环单侧多发梗死(17.1％)与小动脉闭塞型有关(P=0.007).结论 缺血性脑卒中患者早期行DWI检查可以预测病因,为制订相关的诊治策略提供有用信息.