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目的讨论大脑中动脉粥样硬化性脑梗死患者DWI成像特征与卒中机制的关系。方法前瞻性纳入49例大脑中动脉粥样硬化性脑梗死患者的DWI资料,根据DWI上病灶数目分为单发和多发脑梗死,并统计其缺血性病灶的分布情况。结果 49例大脑中动脉粥样硬化性脑梗死患者中多发脑梗死31例(63.3%),单发脑梗死18例(36.7%)。结论多发性脑梗死为大脑中动脉粥样硬化性脑梗死最常见类型,其中呈深的、成链条状分布的内交界区梗死为多发性脑梗死最常见表现类型,其可能发病机制为动脉-动脉栓塞或血流动力学低灌注或二者的共同作用。深穿支梗死是单发性脑梗死最常见的表现类型,其发病机制可能为局部分支闭塞或共存的远端栓塞。
Objective To discuss the relationship between DWI features and stroke mechanism in patients with cerebral atherosclerosis cerebral infarction. Methods Forty-nine patients with cerebral atherosclerosis cerebral infarction were prospectively enrolled. DWI data were divided into single and multiple cerebral infarction according to the number of lesions on DWI, and the distribution of ischemic lesions was calculated. Results Among the 49 patients with middle cerebral artery atherosclerotic cerebral infarction, there were 31 cases of multiple cerebral infarction (63.3%) and 18 cases of single cerebral infarction (36.7%). Conclusions Multiple cerebral infarction is the most common type of cerebral atherosclerotic cerebral infarction. The deep, chain-like internal border area infarction is the most common type of multiple cerebral infarction. Its possible pathogenesis is arterial- Arterial embolism or hemodynamic perfusion or a combination of the two. Deep penetrating infarction is the most common manifestations of single cerebral infarction, its pathogenesis may be partial branch occlusion or coexistence of distal embolization.