急性脑桥梗死进展发生的影像学特点

目的探讨急性脑桥梗死进展发生的影像学特点。方法采用头颅MRI及磁共振血管造影(MRA)检查,对151例急性脑桥梗死患者的影像学特征进行分类,将其分为2组,进展组42例,非进展组109例。比较2组患者的影像学分型及梗死部位的不同。结果 151例急性脑桥梗死患者中发生进展者占27.8%,非进展者占72.2%;进展组与非进展组在一般情况、危险因素、实验室检查、美国国立卫生研究院卒中量表评分、药物治疗等方面比较差异无统计学意义(P>0.05)。进展组基底动脉分支病变的发生率(73.8%)明显高于非进展组(34.9%,P=0.000),同时发现,进展组下部脑桥梗死的发生率(42.9%)明显高于非进展组(24.8%,P=0.029)。结论基底动脉分支病变和下部脑桥梗死可能是急性脑桥梗死进展发生的重要预测指标,对可疑的急性脑桥梗死患者,及时行头颅MRI(包括弥散加权成像)及MRA检查,明确其影像学分型及梗死部位,对预防急性脑桥梗死进展的发生可能具有重要意义。

Neuroimaging characteristics of patients with progressive acute pontine infarction

Objective To study the neuroimaging characteristics of patients with progressive acute pontine infarction(API).Methods Neuroimaging characteristics of 151 patients with progressive API detected by cranial MRI and MRA were classified.The 151 patients were divided into progressive API group(n=42) and non-progressive API group(n=109).Types of neuroimaging and sites of pontine infarction were compared between the two groups.Results The incidence of progressive and non-progressive API was 27.8% and 72.2% respectively in the 151 patients.No significant difference was found in the general conditions,risk factors,laboratory findings,NIHSS scores,and medications between the two groups(P>0.05).The incidence of basilar artery branch lesions and lower pontine infarction was significantly higher in progressive API group than in non-progressive API group(73.8% vs 34.9%,P=0.000;42.9% vs 24.8%,P=0.029).Conclusion Basilar artery branch lesions and lower pontine infarction may be the important predictors for progressive API.Immediate cranial MRI(including diffusion weighted imaging) and MRA are of great significance in typing the neuroimaging,locating the sites of infarction and preventing the progression of API in patients wih suspicious pontine infarction.