急性脑梗死大脑皮、髓静脉的磁敏感加权成像解剖研究

目的　利用磁敏感加权成像(susceptibility weighted imaging, SWI)技术分析脑梗死患者大脑皮、髓质静脉的不对称征与脑梗死严重度和梗死灶解剖学特征的相关性，为临床急性脑梗死诊断、治疗提供影像参考。 方法　选取38例超急性期、62例急性期脑梗死患者，采用磁共振扫描，比较静脉不对称组与对称组的脑梗死严重度差异以及梗死灶解剖学特征差异。 结果 对于超急性期，静脉不对称组与对称组NIHSS评分分别为8（4~8.8）、5.5（3~8），两组评分无显著性差异（P=0.058）。对于急性期，静脉不对称组与对称组NIHSS评分分别为5（2~7）、1.5（1~2），两组评分有显著性差异（P=0.043）。大脑前循环和后循环动脉梗塞静脉不对称出现率分别为48(82.8%)、 12(28.6%)，两者有显著性差异（P<0.001）。 结论 急性期脑梗死的静脉不对称征可反映卒中更高的严重度，而超急性期则不然。大脑前循环梗塞更趋向于形成静脉不对称征。

The anatomic study of cerebral cortical and medullary veins on susceptibility-weighted imaging in acute ischemic stroke

Objective　To assess the features of the cortical and medullary veins on the susceptibility weighted imaging（SWI） in patients with hyperacute and acute ischemic stroke and its relationship with stroke severity and the anatomical characteristics of the infarctions to provide the clinical diagnosis information and treatment related reference and guidance for patients with stroke. Methods We selected 38 stroke patients hyperacute ischemic and 62 patients with acute ischemic stroke. The examinations were conducted using MRI. The stroke severity and anatomy of infracts were assessed.　Results　The NIHSS score was 8（4~8.8）in PAVS（+） and 5.5（3~8）in PAVS（-） for hyperacute ischemic stroke (P=0.058). The NIHSS score was 5 (2~7) in PAVS（+） and 1.5 (1~2) in PAVS（-） for acute stroke (P=0.043). The frequency of PAVS was 82.8% in the anterior circulation ischemic stroke and 28.6% in the posterior circulation ischemic stroke (P<0.001). Conclusion　The appearance of PAVS represents poorer stroke severity in the acute ischemic stroke, except for the hyperacute ischemic stroke. The anterior circulation acute stroke tends to represent PAVS.