MRI-T2FLAIR高信号血管征与急性大脑中动脉闭塞患者预后的相关性研究

摘要

目的 探讨磁共振T2液体衰减反转恢复序列(FLAIR)高信号血管征象(HVS)在急性大脑中动脉闭塞患者临床预后评估中的意义.方法 回顾性分析2013年8月至2015年8月上海交通大学医学院附属苏州九龙医院神经内科住院的57例急性大脑中动脉闭塞患者的资料,分为远端HVS组28例和无远端HVS组29例(近端HVS组8例,HVS阴性组21例),所有患者均在24 h内进行完整的MRI检查(包括FLAIR、DWI及MRA)及CTA检查,比较患者弥散加权成像(DWI)的梗死体积,并对患者入院时、出院时的美国国立卫生院神经功能缺损评分(NIHSS评分)以及出院30 d的改良Rankin评分(mRS评分)进行比较分析.结果 急性大脑中动脉闭塞患者远端HVS组DWI序列的梗死体积,入院时、出院时的NIHSS评分及出院30 d的改良Rankin评分优于无远端HVS组(P＜0.05).结论 MRI-T2 FLAIR序列HVS在急性大脑中动脉闭塞患者的预后评估中有一定的参考价值.%Objective To investigate the significance of MRI T2 fluid-attenuated inversion recovery hyperintense vessel sign (FLAIR HVS)in clinical prognosis evaluation of the patients with acute middle cerebral artery irnfarction.Methods The data in 57 inpatients with acute middle cerebral artery infarction in our hospital from Aug.2013 to Aug.2015 were retrospectively analyzed.All cases were performed the intact MRI examination(ineluding FLAIR,DWI and MRA)and CTA.The infarct volume with DWI,national institute of health stroke scale(NIHSS)score and modified Rankin Scale(mRS)score on 30 d after discharge were performed the comparative analysis.Results Fifty-seven cases of middle cerebral artery occlusion were divided into the distal HVSgroup and non-distal HVS group(8 cases in proximal HVS group,21 cases in HVS negative group).The infarction volume of DWI sequence,NIHSS scores at admissiom and discharge and mRS score on 30 d after discharge in the distal HVS group were superior to those in the non-distal HVS group(P＜0.05).Conclusion MRI-T2 FLAIR sequence HVS has certain reference value in the prognosis evaluation in the patients with middle cerebral artery occlusion.