高分辨率MRI评估自发性头颈动脉夹层与缺血性卒中的关系

目的 采用高分辨率MRI（HR-MRI）观察自发性头颈动脉夹层（SCAD）影像学表现，分析其与急性缺血性卒中的关系。方法 收集23例SCAD患者的HR-MRI资料，观察其HR-MRI表现，并根据SCAD所在血管节段供血区是否发生急性缺血性卒中将其分为卒中组和非卒中组，分析SCAD的HR-MRI表现与急性缺血性卒中的关系。结果 21例SCAD、84个血管节段纳入研究。共27个节段存在SCAD，累及颈内动脉系统11个节段、椎动脉系统16个节段；其中11个发生供血区急性缺血性卒中（卒中组），16个未发生急性缺血性卒中（非卒中组）。卒中组管腔狭窄及壁内血肿比例54.55%（6/11）及72.73%（8/11）]大于非卒中组19.18%（14/73）及1.37%（1/73）），差异均有统计学意义（P均<0.05）；管腔狭窄及壁内血肿与急性缺血性卒中显著相关（OR分别为4.82及3.75，P均<0.05）。结论 SCAD最常见HR-MRI表现为管腔狭窄和/或壁内血肿，二者均系缺血性卒中的危险因素。

High-resolution MRI in assessment of relationship of spontaneous cervicoce-rebral arterydissection and acute ischemic stroke

Objective To observe MRI manifestations of spontaneous cervicoce-rebral artery dissection (SCAD) using high-resolution MRI (HR-MRI),and to analyze their relationship with acute ischemic stroke. Methods HR-MRI data of 23 patients with SCAD were collected. HR-MRI manifestation of SCAD were observed, and the vascular segments involved by SCAD were divided into stroke group and non-stroke group according to whether acute ischemic stroke occurred in their blood supply area. Then the correlation of HR-MRI manifestations of SCAD and acute ischemic stroke were analyzed.Results Totally 21 SCAD patients and 84 vascular segments were enrolled in this study. A total of 27 vascular segments were found with SCAD, including 11 segments involving internal carotid artery system and 16 segments involving vertebral artery system, among which 11 vascular segments were found with ischemic stroke (stroke group), while 16 were not(non-stroke group).The proportion of lumen stenosis and intramural hematoma in stroke group (54.55%6/11] and 72.73%8/11]) were all higher than those in non-stroke group (19.18%14/73] and 1.37%1/73], both P<0.05). Significant correlation was observed among lumen stenosis, intramural hematoma and acute ischemic stroke (OR=4.82,3.75both P<0.05)].Conclusion The most common HR-MRI manifestations of SCAD are lumen stenosis and/or intracranial hematoma, both being rick factors of ischemic stroke.