摘要
目的探讨缺血性卒中早期的影像学检查是否有助于判断病因。方法回顾性调查急性缺血性卒中患者226例,探讨早期的弥散加权成像(DWI)的影像学表现与病因的相关性。结果早期的DWI表现与病因有关(rs=-0.245,P=0.000)。其中,10例单发的皮质皮质下梗死(χ2=16.591,P=0.000)、17例多发的分水岭梗死(χ2=7.156,P=0.007)、39例散发性梗死(χ2=20.846,P=0.000)和17例位于前循环的多发性梗死(χ2=7.156,P=0.007),病因多为大血管病变;71例小的穿通支梗死病因多为小血管病变(χ2=174.308,P=0.000)。除此之外,还有相当一部分小穿通支梗死(12/71,16.90%)具有其他原因(χ2=7.112,P=0.008);大部分(13/18)皮质梗死病因不明(χ2=19.650,P=0.000)。结论缺血性卒中急性期的DWI检查可帮助确定病因。
ObjectiveTo evaluate the relationship between etiology and diffusion weighted imaging (DWI) patterns in acute stage of ischemic stroke.MethodsWe retrospectively investigated 226 patients admitted to Prince of Wales Hospital in Hong Kong during January to July 2002 who were diagnosed as having acute ischemic stroke or transient ischemic attack (TIA), and who were performed DWI at the acute stage. The modified-TOAST(Trial of Org 10172 in Acute Stroke Treatment)classification and the imaging appearance on DWI were analyzed. The relationship between early imaging on DWI and etiology was investigated.ResultsThe imaging appearance on DWI was related with etiology (r_s=-0.245,P=0.000). Ten single cortico-subcortical infarcts (χ~2=16.591,P=0.000), 17 multiple border zone infarcts (χ~2=7.156,P=0.007), 39 scattered infarcts involving one artery territory (χ~2=20.846, P=0.000), and 17 multiple infarcts involving more than one artery territory of anterior circulation (χ~2=7.156,P=0.007) were mostly caused by large artery disease, and 71 small infarcts in basal ganglion and brain stem were mostly caused by small vessel disease (χ~2=174.308, P=0.000). In addition, some small infarcts (12/71,16.90%) possessed others causes(χ~2=7.112,P=0.008). Most single cortical infarcts (13/18)were detected without definite cause (χ~2=19.650, P=0.000).ConclusionThe DWI patterns in acute stage should be helpful to verify etiology of ischemic stroke.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2005年第5期301-304,共4页
Chinese Journal of Neurology
