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目的:探讨大脑中动脉闭塞(MCAO)急性缺血性卒中患者远段FLAIR血管高信号征(FVH)的血流动力学基础。方法:对38例CTA诊断的单侧MCAO急性缺血性卒中患者于发病3天内行MRI和CTP检查。评价MRI T2-FLAIR序列上FVH的显示,分为无远段FVH和远段FVH两组;评价CTP原始图像患侧代偿血流充盈情况,分为无代偿血流、代偿血流充盈顺序混乱和代偿血流逆向逐渐充盈三组;比较FVH的显示与CTP原始图像患侧代偿血流充盈情况。结果:38例单侧MACO急性缺血性卒中患者,16例无远段FVH,其中5例CTP原始图像患侧无代偿血流,6例代偿血流充盈顺序混乱;22例远段FVH,CTP原始图像患侧均显示代偿血流逆向逐渐充盈;共33例患者(86.8%)FVH的显示和CTP原始图像患侧代偿血流(即侧支循环)充盈情况相符。结论:MCAO急性缺血性卒中患者远段FVH的形成可能源于侧支循环。
Objective: To investigate the hemodynamic basis of distal FLAIR vascular signal (FVH) in patients with middle cerebral artery occlusion (MCAO) acute ischemic stroke. Methods: Thirty-eight patients with unilateral MCAO acute ischemic stroke diagnosed by CTA were examined by MRI and CTP within 3 days after the onset of disease. FVH on MRI T2-FLAIR sequence was evaluated and divided into two groups: distal FVH and distal FVH. The filling of compensatory blood flow on the affected side of CTP was evaluated and divided into compensatory blood flow, compensatory blood flow filling The order of confusion and compensatory blood flow were reversed gradually filled three groups; comparison of FVH display and CTP original image ipsilateral compensatory blood flow filling situation. Results: Among the 38 unilateral MACO patients with acute ischemic stroke, 16 had no distal FVH, 5 of them had no compensated blood flow on the ipsilateral side of the original CTP and 6 had compensatory blood flow filling sequence disorder. Twenty-two patients with distal FVH The CTP images showed that the compensated blood flow was gradually reversed in the affected side. The FVH in 33 patients (86.8%) was consistent with the compensatory blood flow (ie, collateral circulation) filling in the CTP original image. Conclusion: The formation of distal FVH in MCAO patients with acute ischemic stroke probably originated from collateral circulation.