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目的:探讨3.0T磁共振的液体衰减反转恢复成像序列(FLAIR)的高信号血管征(HVS)与磁敏感加权成像(SWI)对急性缺血性脑卒中(AIS)临床对比研究应用价值。方法:62例AIS(<72 h)均行常规MRI、MRA及SWI检查患者,利用FLAIR与SWI联合应用对AIS的近端HVS与血管磁敏感征(SVS)和远端HVS与病灶周围软脑膜血管的侧支循环血管扩张程度相关性分析。结果:在62例AIS中大脑中动脉(MCA)近端高信号HVS阳性39例,阴性23例,分别占总数62.9%、37.1%;远端HVS阳性51例、阴性11例,分别占总数82.2%、17.8%;SVS阳性53例、阴性9例,分别占总数85.5%、14.5%;病灶周围软脑膜血管与同镜像区扩张49例,无扩张13例,分别占总数79.0%、20.1%;AIS的近端HVS征与SWI的SVS征责任血管相关性分析,对t检验具有统计学意义(χ~2=8.255,P=0.004,<0.01)。MCA远端在T2 FLAIR的HVS征与病灶周围有、无软脑膜血管显示程度相关性分析对t检验具有一致性(χ~2=0.207,P=0.649>0.05)。结论:MCA的SVS和近端HVS对AIS的责任血管具有明显一致性,且SWI对MCA的血栓检出率明显优于T2 FLAIR,MCA远端的HVS征与病灶周围有、无软脑膜血管具有一致性,同时对危重患者优化检查流程,为临床制定正确的治疗方案和预后判断具有重要临床意义。
Objective: To investigate the clinical value of high signal vascular signs (HVS) and magnetic susceptibility weighted imaging (SWI) in acute ischemic stroke (AIS) with 3.0T magnetic resonance imaging (FLAIR). Methods: Sixty-two patients with AIS (<72 h) underwent routine MRI, MRA and SWI examinations. The combined application of FLAIR and SWI was used to evaluate the effect of proximal HVS and Vascular Susceptibility Syndrome (SVS) Correlation analysis of degree of dilatation of collateral circulation in blood vessels. Results: There were 39 cases of HVS positive in the proximal middle cerebral artery (MCA) of 62 AIS cases, and 23 cases were negative, accounting for 62.9% and 37.1% respectively. 51 cases were distal HVS and 11 were negative, accounting for 82.2% Accounting for 85.5% and 14.5% respectively. There were 49 cases with dilated mediastinal vessels and the same mirror region, 13 cases without dilation, accounting for 79.0% and 20.1% of the total respectively. The correlation analysis of AIS with proximal SVS and SWI of SVS was statistically significant for t test (χ ~ 2 = 8.255, P = 0.004, <0.01). The distal end of MCA was found around the HVS signs and lesions of T2 FLAIR, and the correlation analysis showed no correlation with tachycardia (p <0.05). CONCLUSIONS: The SVS and proximal HVS of MCA are consistent with the responsibility vessels of AIS, and the detection rate of thrombus by SWI is superior to that of T2 FLAIR. The distal HVS sign of MCA is associated with the presence of leptomeningeal vessels Consistency, and optimize the inspection process for critically ill patients for the clinical development of the correct treatment and prognostic judgment of great clinical significance.