大脑中动脉高密度征的动态CT表现与临床

目的探讨大脑中动脉高密度征(HMCAS)在大脑中动脉(MCA)供血区超急性期梗死的诊断价值。方法对46例MCA供血区超急性期脑梗死(发病6h内)的CT征象及临床表现进行分析,并定期复查CT观察其动态变化。结果MCA供血区超急性期脑梗死46例中表现为HMCAS者32例(71.1%),临床均为完全前循环梗死(TACI),25例死亡(78.1%),其中HMCAS进展且合并MCA点状征的14例中12例(85.7%)死亡,其余均遗留严重神经功能缺损;而无HMCAS的14例中8例为部分前循环梗死(PACI),6例为TACI,仅2例(14.3%)死亡,两者差异具有统计学意义(P<0.01)。3例HMCAS在复查随访时消失,病人病情好转且均转化为出血性脑梗死。结论大脑中动脉高密度征的动态CT变化有助于MCA供血区超急性期脑梗死的诊断及预后判断。

Dynamic Changes of CT Manifestations and Clinic of Hyperdense Middle Cerebral Artery Sign

Objective To investigate the diagnostic value of hyperdense middle cerebral artery sign(HMCAS)in hyperacute infarction.Methods Clinical characteristics and CT findings were analyzed in 46 cases with hyperacute middle cerebral artery (MCA)infarction within 6 hours.Its dynamic changes were followed-up with CT examination.Results HMCAS appeared in 32 cases,they were all total anterior circulation infarct(TACI)in clinic and 25 cases died.12 cases died in 14 cases with HMCAS progression and dot sign ,another 2 cases remained severe defect of nerve function.Of the 14 cases without HMCAS,8 cases were partial anterior circulation infarct(PACI),6 cases were TACI and only 2 cases died.The difference was of statistical significance (P<0.01).HMCAS disappeared in 3 cases at follow-up CT examination,the patients were better and furthermore changed to hemorrhagic infarction.Conclusion CT dynamic changes of HMCAS are helpful in diagnosis and assessment of prognosis of hyperacute MCA infarction.