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目的与血管造影对照探讨急性脑梗死磁共振快速液体衰减反转恢复(FLAIR)序列血管高信号(FLAIRvascular hyperintensities,FVH)的形成机制。资料与方法回顾性分析9例急性大脑中动脉闭塞6 h内患者的磁共振FLAIR序列及血管造影图像。评价急性脑梗死患者FVH的发生率、位置及形态学特征,并以血管造影分析其血流动力学特征。结果 9例患者FVH出现率为100%。FVH最常见于外侧裂(100%),颞叶或邻近颞叶为89%,顶叶为22%。FVH于颈内动脉血管造影上显示来自大脑前动脉软脑膜支不同程度侧支循环,微导管通过大脑中动脉闭塞段造影显示对比剂滞留,并无充盈缺损。结论急性脑梗死患者FVH形成的原因可能为近端血管闭塞,软脑膜侧支逆向缓慢血流代偿,而并非血管内血栓形成。
Objective To investigate the formation mechanism of FLAIR vascular hyperintensities (FVH) in acute cerebral infarction (AMI) with contrast-enhanced angiography. Materials and Methods Retrospective analysis of magnetic resonance FLAIR sequences and angiographic images of 9 patients with acute middle cerebral artery occlusion within 6 h. To evaluate the incidence, location and morphological characteristics of FVH in patients with acute cerebral infarction. The hemodynamic characteristics were analyzed by angiography. Results The incidence of FVH in 9 patients was 100%. FVH is most commonly seen at the lateral cleft (100%), with 89% in the temporal or proximal temporal lobe and 22% in the parietal lobe. FVH showed different degrees of collateral circulation from the anterior cerebral artery in the internal carotid artery angiography. The microcatheter occluded by contrast medium in the middle cerebral artery occlusion, there was no filling defect. Conclusion The cause of FVH in patients with acute cerebral infarction may be due to proximal vascular occlusion, and retrograde flow compensatory rather than intravascular thrombosis.