心房颤动引起心源性脑栓塞颅内梗死灶空间分布特点

目的：探讨心房颤动引起心源性脑栓塞颅内梗死灶空间分布特点。方法：回顾性分析66例由心房颤动引起心源性脑栓塞患者早期弥散加权成像（DWI）的特征。结果：66例患者中有1例患者DWI上未见病灶，65例患者DWI上可见本次责任病灶。多发梗死灶患者有21／65例，占32．31％；双侧前循环供血区同时梗死7／21例，占多发脑梗死灶患者的33．33％；45例单独前循环供血区梗死患者中，左侧前循环供血区梗死23／45例（51．11％），右侧前循环供血区梗死15／45例（33．33％），脑栓塞以左侧居多；前循环供血区中大脑中动脉（MCA）供血区发生栓塞的概率最大（35／45例，77．78％），35例大脑MCA供血区梗死患者中，皮质下梗死9／35例（25．71％）]和皮质-皮质下梗死22／35例（62．86％）1的患者例数明显多于皮质区梗死4／35例（11．43％）]患者。结论：心房颤动引起心源性脑栓塞的脑内病灶左侧脑多见，大脑中动脉更易发生，皮质下和皮质-皮质下梗死多于皮质区梗死。

The Spatial Distribution Characteristics of Intracranial Infarct Lesions of Cardiogenic Cerebral Embolism Induced by Atrial Fibrillation

Aim： To identify the spatial distribution characteristics of intracranial infarct lesions of cardiogenic cerebral embolism induced by atrial fibrillation. Methods： We analyzed the initial diffusion-weighted imaging （DWI） findings of 66 consecutive patients with cardiogenic cerebral embolism induced by atrial fibrillation. Results： Multiple lacunar stroke were detected in 21 of 65 patients （32.31%） with cardiogenic cerebral embolism induced by atrial fibrillation. Of the 21 patients there were 7 patients who were found to have multiple infarcts involving more than one artery territory of anterior circulation. Nearly half（23/45）of the patients were found to have single or multiple lesions in the left-unilateral anterior circulation, that was much more than the patients whose lesions were in the right-unilateral anterior circulation（15/45）. In the anterior circulation, lesions were showed more frequently in the middle cerebral artery（MCA） territory （35/45）. Corticosubcortical lesions （22/35） and subcortical lesions （9/35） were much more frequently than cortical lesions （4/35）. Conclusion： In patients with cardiogenic cerebral embolism induced by atrial fibrillation, the intracranial infarct lesions were showed more frequently in the left-unilateral anterior circulation, the MCA territory, subcortical lesion and corticosubcortical.