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目的探讨缺血性卒中早期的影像学检查是否有助于判断病因。方法回顾性调查急性缺血性卒中患者226例,探讨早期的弥散加权成像(DWI)的影像学表现与病因的相关性。结果早期的DWI表现与病因有关(rs=-0.245,P=0.000)。其中,10例单发的皮质皮质下梗死(χ2=16.591,P=0.000)、17例多发的分水岭梗死(χ2=7.156,P=0.007)、39例散发性梗死(χ2=20.846,P=0.000)和17例位于前循环的多发性梗死(χ2=7.156,P=0.007),病因多为大血管病变;71例小的穿通支梗死病因多为小血管病变(χ2=174.308,P=0.000)。除此之外,还有相当一部分小穿通支梗死(12/71,16.90%)具有其他原因(χ2=7.112,P=0.008);大部分(13/18)皮质梗死病因不明(χ2=19.650,P=0.000)。结论缺血性卒中急性期的DWI检查可帮助确定病因。
Objective To investigate whether early imaging of ischemic stroke can help determine the cause. Methods A retrospective study of 226 patients with acute ischemic stroke was conducted to investigate the relationship between the imaging findings and etiology of early diffusion-weighted imaging (DWI). Results Early DWI was associated with etiology (rs = -0.245, P = 0.000). Among them, 10 cases had single cortical subcortical infarction (χ2 = 16.591, P = 0.000), 17 cases of multiple watershed infarction (χ2 = 7.156, P = 0.007) and 39 cases of sporadic infarction (χ2 = 20.846, P = ) And 17 cases of multiple infarcts located in the anterior circulation (χ2 = 7.156, P = 0.007). Most of the etiological factors were macroangiopathy. The causes of small infarction in 71 patients were mostly small vessel disease (χ2 = 174.308, P = 0.000) . In addition, a small proportion of small penetrating branches (12/71, 16.90%) had other causes (χ2 = 7.112, P = 0.008); the cause of most (13/18) cortical infarcts was unknown (χ2 = 19.650, P = 0.000). Conclusion DWI in the acute phase of ischemic stroke may help determine the cause.