15例急性CO中毒伴发急性脑梗死的临床及MRI、MRA研究

摘要

Objective To evaluate the diagnostic value of MRI and MRA in acute carbon monoxide (CO) poisoning with acute cerebral infarction.Methods We retrospectively analyzed and summarized the MRI and MRA data of 15 patients with acute carbon monoxide (CO) poisoning associated with acute cerebral infarction.Results Lesion position of 15 cases of acute cerebral infarction:MRI appeared as dotted,a sheet abnormality signal;DWI displayed high signal;a low signal was shown as the ADC;ADC value was(0.55±0.14)×10-3 mm2/s;Lesion diameter was (8.62±9.27)mm.Lesions distributed as follows:10 cases of brain lobes,7 cases of basal ganglia and lateral ventricle,2 cases of cerebellum,2 cases of globus pallidus,1 case brainstem.12 cases of periventricular white matter before and after the sheet-like angle,length cloudy T1,long T2 abnormal signal lesions;11 cases of bilateral basal ganglia and lateral ventricle point-like long T1,long T2 abnormal signal for the old lacunar infarction;7 cases of brain atrophy.13 cases of MRA showed:8 cases of arterial stenosis accounted for 61.53%;5 cases of arterial lumen stiffness accounted for 38.46%.Conclusion Application of head MRI and MRA have certain practical value in the early diagnosis,severity and prognosis of acute carbon monoxide poisoning with acute cerebral infarction.%目的 评价MRI、MRA对急性CO中毒伴发急性脑梗死的诊断价值.方法 回顾分析15例经临床确诊的急性CO中毒伴发急性脑梗死患者的头颅MRI、MRA资料.结果 15例患者急性脑梗死病变部位:MRI为点状、片状异常信号;DWI表现为高信号;ADC为低信号;ADC值为(0.55±0.14)×10-3 mm2/s;病灶直径(8.62±9.27)mm.病灶部位:10例脑叶,7例基底节及侧脑室旁,2例小脑,2例苍白球,1例脑干.12例侧脑室前后角白质周围片状、云雾状长T1、长T2异常信号病灶;11例双侧基底节及侧脑室旁点状长T1、长T2异常信号为陈旧性腔隙性梗死;7例脑萎缩.13例MRA表现:8例(61.53%)动脉狭窄,5例(38.46%)动脉管腔僵硬.结论 应用头颅MRI、MRA对急性CO中毒伴发急性脑梗死的早期临床诊断、病情程度及预后的评估有一定的实用价值.