纹状体内囊梗死34例患者临床和影像特征

目的 分析纹状体内囊梗死(SCI)的临床和影像特征并探讨其发病机制.方法 回顾分析34例SCI患者的临床及影像资料.将患者分为皮质型SCI(CSCI)和非皮质型SCI(NCSCI)2组,进行临床和影像资料的对比分析.结果 CSCI 23例,NCSCI 11例.CT血管成像共检出大脑中动脉和颈内动脉狭窄或闭塞25例.CT脑灌注成像检出26例大脑中动脉供血区内血流灌注减低,其中19例累及广泛的大脑中动脉供血区.CSCI患者中检出上述动脉狭窄或闭塞21例,明显高于NCSCI患者中的4例(χ~2=3.27,P=0.020),CSCI患者中检出MCA供血区内血流减低区21例,明显高于NCSCI患者中的5例(χ~2=8.62,P=0.007).结论 SCI有临床和影像特征,大部分由于MCA原位病变所致.动脉病变和其造成的灌注减低是发生皮质症状的重要原因.

Clinical and imaging analysis in 34 patients with striatocapsular infarction

Objective To study the clinical characteristics and neuroimagings of striatocapsular infarction (SCI) and its pathogenesis.Methods Thirty-four patients with SCI diagnosed by CT and MRI were recruited in this retrospective study,including 23 certical SCI (CSCI) and 11 noncertical SCI (NCSCI).The clinical symptoms and CT angiography (CTA) and CT perfusion (CTP) imagings were reviewed to compare differences between CSCI and NCSCI.Results The CTA showed severe stenosis or occlusion MCA or ICA in 25 cases and CTP showed hypo-perfusion area in MCA territory in 26 cases,of those in 19 cases hypoperfusion involved massive area in MCA territory.The stenosis or occlusion in MCA or ICA and the hypoperfusion area in MCA territory were greater in CSCI patients than in NCSCI patients (χ~2 = 3.27,P =0.020;χ~2 = 8.62,P =0.007).Conclusions SCI can be divided into CSCI and NCSCI subgroups.In this study most SCI were caused by occlusive lesion in original segment of MCA.The MCA or ICA lesion and the massive hypo-perfusion in MCA territory are important causes of cortical symptoms.