MR扩散加权成像脑梗死灶形态特征诊断脉络膜前动脉梗死的价值

目的探讨脉络膜前动脉（AchA）梗死灶形态特征对脉络膜前动脉梗死的诊断价值。 方法选择2016年4月至2018年4月于徐州医科大学附属沐阳医院诊断为急性AchA梗死患者100例,记录患者年龄、性别、卒中史、高血压、糖尿病、心房颤动和冠心病情况,应用美国国立卫生研究院卒中量表（NIHSS）评估疾病严重程度及入院NIHSS评分。所有患者均接受头颅MR及扩散加权成像（DWI）,并根据梗死灶最大径大小分为小梗死灶（最大径<15 mm）,中梗死灶（最大径15~20 mm）及大梗死灶（最大径>20 mm）。 结果AchA梗死灶直径6.1~29.3 mm,平均（14.6±4.8）mm,小梗死灶55例、中梗死灶31例、大梗死灶14例。索条状与其他形态梗死灶在高血压、糖尿病、心房颤动、冠心病、卒中史方面差异无统计学意义;索条状梗死灶患者出现言语障碍比例高于、最大径大于其他形态梗死灶患者（P=0.006、0.001）。大、中、小梗死灶患者在高血压、糖尿病、心脏病、卒中史等方面比较差异无统计学意义,言语障碍、感觉障碍比例差异有统计学意义（P=0.009、0.047）。 结论AchA梗死患者梗死灶多表现为索条形,且形态与梗死灶大小有关;梗死灶的形态特征对AchA梗死的诊断具有一定价值。

Diagnostic value of morphological features detected by diffusion weighted imaging in anterior choroidal artery infarction

ObjectiveTo observe the imaging characteristics of acute ischemic stroke (AIS) of the anterior choroidal artery (AchA), and then explore the diagnostic value of morphological features of AchA infarction. MethodsOne hundred consecutively patients with AIS who had an imaging diagnosis of AchA infarction were selected. Data including age, gender, stroke history, hypertension, diabetes, atrial fibrillation (AF), and coronary heart disease were recorded. The severity of illness was evaluated using the National Institute of Health stroke scale (NIHSS) and NIHSS score at admission was recorded. All patients underwent brain MR imaging (MRI) and diffusion weighted imaging after admission. According to the maximum diameter of infarcts, they were divided into small infarcts (maximum diameter <15 mm), medium infarcts (maximum diameter 15-20 mm), and large infarcts (maximum diameter >20 mm). ResultsThe diameter of AchA infarct was 6.1-29.3 mm, with an average of (14.6±4.8) mm, including 55 small infarctions, 31 medium infarctions, and 14 large infarctions. No difference was found in terms of hypertension, diabetes, atrial fibrillation, coronary artery disease, or stroke history between cord-like infarcts and infarcts of other shapes. In terms of the proportion of speech disorders and diameter, there were greater in patients with cord-like infarcts were than in patients with infarcts of other shapes (P=0.006, 0.001). There was no significant difference in hypertension, diabetes, heart disease and stroke history among the patients with large, medium and small infarcts, but there was a significant difference in the proportion of speech disorder and sensory disorder (P=0.009, 0.047). ConclusionAchA infarcts mostly manifest as long cord-like infarcts on diffusion weighted imaging, and the shape is associated with the size of infarcts. The morphological characteristics of infarcts have diagnostic value for AchA infarction.