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单侧颈内动脉狭窄或闭塞的影像学梗死类型及脑血流动力学评价
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Journal Article
单侧颈内动脉狭窄或闭塞的影像学梗死类型及脑血流动力学评价
2011
Overview
目的研究单侧动脉粥样硬化性颈内动脉狭窄或闭塞（ICASO）性脑梗死患者影像学梗死类型及其脑血流动力学改变，以探讨脑梗死发生的可能机制。方法87例经脑血管造影明确诊断的单侧动脉粥样硬化性ICASO性脑梗死患者，MRI和TCD检查分析影像学梗死类型及不同类型之间存在的脑血流动力学差异。结果MRI所见脑梗死类型共分为区域梗死（30例，34．48％）、皮质下梗死（27例，31．03％）、边缘带梗死（18例，20．69％）和弥散小梗死（12例，13．79％），不同脑梗死类型发生率之间差异具有统计学意义（X^2=7．156，P=0．028）；脑梗死类型与颈内动脉狭窄程度呈负相关（r=-0．275，P=O．010），重度狭窄以皮质下梗死、边缘带梗死多见（均11／36，30．56％），完全闭塞则以区域梗死常见（17／34，50．00％）。脑血流动力学观察显示，不同脑梗死类型患侧大脑中动脉平均血流速度和搏动指数与健侧存在明显的不对称性（均P=0．000），其中以区域梗死最低，次之为边缘带梗死。结论ICASO以区域梗死多见，且脑血流动力学障碍存在于各种脑梗死类型中。提示应综合考虑脑梗死类型和脑血流动力学改变，从而选择恰当的防治方法。
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