MCA供血区急性脑梗死SWI图像与脑血管反应性的相关性

目的:分析大脑中动脉供血区(MCA)急性脑梗死患者的磁敏感加权成像(SWI),探讨梗死侧侧脑室旁深部髓质静脉(DMV)数量与脑血管反应性(CVR)的相关性。方法:回顾性纳入首次发生患侧MCA供血区卒中患者109例,并已完成TCD CO_2负荷实验和SWI等检查。根据SWI图像将DMV数量分为3级,5条为1级;5-10条为2级;10条为3级,分析DMV分级与CVR的关系。结果:根据排除标准共纳入MCA供血区急性脑梗死患者53例,DMV 1级、2级和3级分别有29、18、6例患者,MCA平均CVR为0.40±0.18。DMV 1级CVR为(0.45±0.22)、2级为(0.35±0.15)和3级为(0.20±0.11),3组患者间CVR存在明显差异(P0.05),且DMV 3级组较DMV 1级组、2级组显著降低(P0.05);Spearman相关分析表明,DMV分级与CVR间存在明显的负性相关关系(P0.001)。结论:MCA供血区脑梗死患者DMV分级与患侧MCA CVR呈负相关关系。

Relationship between Susceptibility-weighted Imaging and CerebrovascularReactivity in Patients with Acute Cerebral Infarction in MCA Territory

Objective:To analyze the susceptibility weighted imaging (SWI) in patients with acute cerebral infarction in middlecerebral artery (MCA) territory, and to explore the relationship between the number of deep medullary vein (DMV) and cerebrovascularreactivity (CVR) in the lateral ventricles of the cerebral infarction.Methods:109 patients with stroke for the first time from the affectedside of MCA were selected, and their CO2 TCD challenge test and SWI examination were completed. According to the numbers of DMVon SWI, they were classified into 3 grades: grade 1: DMV <5; grade 2: DMV 5-10; grade 3: DMV>10. The relationship between DMVclassification and CVR were analyzed.Results:According to the exclusion criteria, a total of 53 patients with acute cerebral infarction inMCA territory were included. There were 29 patients in DMV grade 1, 18 in DMV grade 2 and 6 in DMV grade 3. The mean CVR ofMCA was (0.40± 0.18). The CVR was (0.45 ± 0.22) in DMV grade 1, (0.35 ± 0.15) in DMV grade 2 and (0.20 ± 0.11) in DMV grade3, and there was a significant difference between three groups (P<0.05). Moreover, the CVR in DMV grade 3 was significantly lowerthan in DMV grade 1 and 2 groups (P<0.05). Spearman correlation analysis showed that there was a significant negative correlationbetween DMV classification and CVR (P<0.001)Conclusion:The DMV grade in patients with cerebral infarction in MCA territory wasnegatively correlated with the CVR in the affected side.