急性皮质下小梗死的影像学特征:大动脉粥样硬化性与小动脉病变性卒中的比较

被引：9

作者：

李兰玉

李焰生

机构：

[1] 上海交通大学医学院附属仁济医院神经内科

来源：

国际脑血管病杂志 | 2011年 / 07期

关键词：

脑梗死; 卒中; 脑动脉疾病; 磁共振成像; 动脉粥样硬化;

D O I：

暂无

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

目的探讨大动脉粥样硬化与小动脉病变所致皮质下小梗死(small subcorticalinfarction,SSI)的影像学差异。方法连续住院的急性SSI患者根据循证缺血性卒中病因分型(SSSTOAST)标准分为大动脉粥样硬化性卒中组和小动脉闭塞性卒中组,比较其影像学特征。结果共纳入118例急性SSI患者,剔除7例为心源性脑栓塞,3例为其他明确病因所致卒中,7例为原因不明性卒中。26例大动脉粥样硬化性卒中组新发梗死灶平均(3.69±5.79)个,50%为多个病灶,以半卵圆中心为主(P<0.01);75例小动脉闭塞性卒中组新发梗死灶平均(1.08±0.51)个,仅3例(3.7%)为多个病灶,且位于不同动脉供血区。与大动脉粥样硬化性卒中组相比,小动脉闭塞性卒中组脑白质病变程度较重(P=0.04)、多伴有无症状梗死(P=0.012)。结论大动脉粥样硬化性SSI多为半卵圆中心的多发性梗死,而小动脉闭塞性SSI则多为单发性梗死,易伴严重的脑白质病变和无症状梗死。

引用

收藏

相关论文

共 10 条

[1]

Diversity of Single Small Subcortical Infarctions According to Infarct Location and Parent Artery Disease Analysis of Indicators for Small Vessel Disease and Atherosclerosis [J].

Nah, Hyun-Wook ;

Kang, Dong-Wha ;

Kwon, Sun U. ;

Kim, Jong S. .

STROKE, 2010, 41 (12) :2822-2827

[2]

Topographic patterns of small subcortical infarcts associated with MCA stenosis: A diffusion-weighted MRI study [J].

Wang, Xin ;

Lam, Wynnie W. M. ;

Fan, Yu Hua ;

Graham, Colin A. ;

Rainer, Timothy H. ;

Wong, Ka Sing .

JOURNAL OF NEUROIMAGING, 2006, 16 (03) :266-271

[3]

An evidence-based causative classification system for acute ischemic stroke [J].

Ay, H ;

Furie, KL ;

Singhal, A ;

Smith, WS ;

Sorensen, AG ;

Koroshetz, WJ .

ANNALS OF NEUROLOGY, 2005, 58 (05) :688-697

[4]

Association of lacunar infarcts with small artery and large artery disease:: a comparative study [J].

Roquer, J ;

Rodríguez Campello, A ;

Gomis, M .

ACTA NEUROLOGICA SCANDINAVICA, 2004, 110 (06) :350-354

[5]

MRI findings of small subcortical "lacunar-like" infarction resulting from large vessel disease [J].

Adachi, T ;

Kobayashi, S ;

Yamaguchi, S ;

Okada, K .

JOURNAL OF NEUROLOGY, 2000, 247 (04) :280-285

[6]

THE WARFARIN-ASPIRIN SYMPTOMATIC INTRACRANIAL DISEASE STUDY [J].

CHIMOWITZ, MI ;

KOKKINOS, J ;

STRONG, J ;

BROWN, MB ;

LEVINE, SR ;

SILLIMAN, S ;

PESSIN, MS ;

WEICHEL, E ;

SILA, CA ;

FURLAN, AJ ;

KARGMAN, DE ;

SACCO, RL ;

WITYK, RJ ;

FORD, G ;

FAYAD, PB .

NEUROLOGY, 1995, 45 (08) :1488-1493

[7]

SILENT BRAIN INFARCTS IN 755 CONSECUTIVE PATIENTS WITH A FIRST-EVER SUPRATENTORIAL ISCHEMIC STROKE - RELATIONSHIP WITH INDEX-STROKE SUBTYPE, VASCULAR RISK-FACTORS, AND MORTALITY [J].

BOON, A ;

LODDER, J ;

HEUTSVANRAAK, L ;

KESSELS, F .

STROKE, 1994, 25 (12) :2384-2390

[8]

STROKE SUBTYPES AMONG CHINESE LIVING IN HONG-KONG - THE SHATIN STROKE REGISTRY [J].

KAY, R ;

WOO, J ;

KREEL, L ;

WONG, HY ;

TEOH, R ;

NICHOLLS, MG .

NEUROLOGY, 1992, 42 (05) :985-987

[9]

The arterial lesions underlying lacunes.[J].C. M. Fisher.Acta Neuropathologica.1969, 1

[10]

各类脑血管疾病诊断要点.[J]..中华神经科杂志.1996, 06