缺血性脑卒中患者脑内微出血的磁共振成像研究

目的分析缺血性脑卒中患者脑内微出血(CBMs)的分布特点及其与陈旧性腔隙性脑梗死和脑白质改变严重程度的关系。方法连续选取住院的缺血性脑卒中患者247例,分析其MRI表现。根据有无CMBs将患者分为CMBs组(72例)和无CMBs组(175例)。记录CMBs的位置和个数、陈旧性腔隙性脑梗死的个数和脑白质改变的严重程度。结果与无CMBs组患者比较,CMBs组患者年龄大、高血压、脑梗死病史、脑白质改变比例均高。CMBs组患者CMBs常见的部位依次为:基底节、皮质及皮质下区、丘脑、脑干及小脑。CMBs的分级与陈旧性腔隙性脑梗死及脑白质改变的严重程度之间具有显著相关性。结论CMBs与脑微血管病变之间有密切关系,其可能是晚期脑微血管病变的标志。

MRI study of cerebral microbleeds in patients with ischemic stroke

Objectives To analyze the distribution of cerebral microbleeds(CMBs)in patients with ischemic stroke and study the relationship between CMBs and the severity of old lacunar infarction and cerebral white matter changes.Methods The study population consisted of 247 consecutive inpatients with ischemic stroke.MRI findings of these inpatients were observed.CMBs were counted respectively according to their locations,including the cortico-subcortical regions,basal ganglia,thalami,brain stem and cerebellum.The number of the old lacunes and the severity of the cerebral white matter changes were also recorded.Based on the occurrence of CMBs,the patients were divided into two groups(72 cases with CMBs;175 cases without CMBs).Results Compared with the patients without CMBs,the patients with CMBs were older and had higher percentages of hypertension,cerebral infarction history and cerebral white matter changes.The most common locations of CMBs in patients with ischemic stroke were basal ganglia,followed by cortico-subcortical region,thalami,brain stem and cerebellum.The severity of CMBs was closely correlated with the severity of lacunar infarction and cerebral white matter changes respectively.Conclusion CMBs are closely related with cerebral microangiopathy and may be a marker of advanced stage of cerebral microangiopathy.