摘要
目的:分析脑血流动力学与缺血性脑卒中患者脑白质病变(WML)严重程度的相关性。方法:缺血性脑卒中患者120例,均行彩色多普勒血流成像及时间飞跃法磁共振血管成像(TOF-MRA)检测,依据Fazekas量表将WML进行分级,比较其收缩期峰值流速(PSV)、舒张末期流速(EDV)、血管阻力指数(RI)、大脑中动脉狭窄远端与近端信号强度比(SIR)与全脑血流灌注量(tCBFV)、前循环脑血流灌注量(aCBFV)、后循环脑血流灌注量(p CBFV),比较大脑中动脉中度、重度狭窄患者SIR值及各区域WML评分,分析各指标相关性。结果:本组中出现WML95例(79.17%),病变位于基底节46例(48.42%)、额叶86例(90.53%)、颞叶48例(50.53%)、顶枕叶56例(58.95%)、幕下区域3例(3.16%);随WML分级增加,患者颈内动脉RI、椎动脉PSV、椎动脉RI增加,颈内动脉EDV及SIR、tCBFV、aCBFV降低,差异有统计学意义(P<0.05);中度狭窄患者SIR值及额叶、颞叶、顶枕叶区域WML评分与重度狭窄者比较差异有统计学意义(P<0.01);相关性分析发现,WML患者PSV、RI与病变分级呈正相关,SIR、tCBFV与病变分级呈负相关,SIR比值与狭窄程度呈负相关(P<0.05)。结论:急性缺血性脑卒中患者脑血流动力学与WML严重程度有一定相关性,血流动力学的退变及脑灌注量降低使WML程度加重。
Objective: To analyze the correlation between cerebral hemodynamics and white matter lesion(WML) severity in patients with ischemic stroke. Methods: A total of 120 patients with ischemic stroke were enrolled. Color Doppler flow imaging and time-lapse magnetic resonance angiography(TOF-MRA)were performed on all patients. WML were graded according to the Fazekas scale. The peak systolic velocity(PSV), end-diastolic flow rate(EDV), vascular resistance index(RI), distal/proximal signal intensity ratio(SIR) of cerebral middle artery stenosis, global cerebral perfusion(tCBFV), anterior circulation cerebral blood flow(aCBFV), and posterior circulation cerebral blood flow(pCBFV) were compared;the SIR values in patients with moderate or severe stenosis of the middle cerebral artery and WML scores in each region were compared, and the correlation of each indicator was analyzed. Results: There were 95 patients with WML(79.17%);among these, the number of cases with the lesion in the basal ganglia, frontal lobes,temporal lobe, top occipital lobe, and area under the curtain was 46(48.42%), 86(90.53%), 48(50.53%), 56(58.95%), and 3(3.16%), respectively. With the increase of WML grade, the internal carotid artery RI,vertebral artery PSV, and vertebral artery RI increased and the internal carotid artery EDV and SIR, tCBFV,and aCBFV decreased(P<0.05). There was a statistically significant difference in the SIR value and WML scores of the frontal, temporal, and occipital lobes between patients with moderate stenosis and severe stenosis(P<0.01). Correlation analysis showed that in WML patients, PSV and RI were positively correlated with lesion grade, SIR and tCBFV were negatively correlated with lesion grade, and SIR was negatively correlated with stenosis degree(P<0.05). Conclusion: The cerebral hemodynamics of patients with acute ischemic stroke has a certain correlation with the severity of WML lesions. Hemodynamic regression and the decrease of cerebral perfusion increase the severity of WML lesions.
作者
刘芳芳
刘自双
陈珊珊
张新峰
LIU Fang-fang;LIU Zi-shuang;CHEN Shan-shan;ZHANG Xin-feng(Geriatric Rehabilitation Center,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)
出处
《神经损伤与功能重建》
2020年第1期6-9,共4页
Neural Injury and Functional Reconstruction
