大脑中动脉M1段闭塞后动脉偏侧优势和动脉内高信号对比研究

目的:探讨单侧大脑中动脉（MCA）M1段闭塞后，磁共振血管成像（MRA）提示同侧大脑前动脉（ACA）及大脑后动脉（PCA）偏侧优势与三维动脉自旋标记（3D ASL）成像提示动脉内高信号之间的相关性。方法:收集2018年1月至2021年7月经MRA提示单侧MCA M1段闭塞患者60例，男34例，女26例，年龄33～78（...

A comparative study of arterial laterality and high signal in middle cerebral artery after M1 segment occlusion

Objective　To investigate the correlation between unilateral middle cerebral artery (MCA) M1 segment occlusion and the unilateral advantages of anterior cerebral artery (ACA) indicated by magnetic resonance angiography (MRA) and posterior cerebral artery (PCA) indicated by 3-dimentional arterial spin labeling (3D ASL). Methods　From January 2018 to July 2021, 60 patients with unilateral MCA M1 segment occlusion indicated by MRA were collected, induding 34 males and 26 females, who were 33-78(51.2±7.6)years old. According to whether there was ACA or PCA unilateral advantages, they were divided into a unilateral advantage group and a control group. Through 3D ASL imaging sequence, the differences between the two groups in intra-arterial high signal display were compared. At the same time, the cerebral blood flow (CBF) of MCA supply area was measured, and the infarct area was calculated according to the DWI sequence. t and χ² tests were used. Results　Among the 60 patients, 87.9% (29/33) of the patients in the lateral dominant group and 48.1% (13/27) of the patients in the control group showed intra-arterial high signal, with a statistical difference (χ²=11.162, P<0.001). The CBF value of the middle cerebral artery blood supply area of the partial advantage group was (56.43±11.65) ml/100 g×min, which was higher than that of the control group (42.58±14.52) ml/100 g×min], with a statistical difference (t=4.101, P<0.001). Meanwhile, the infarct area of the partial advantage group was smaller than that of the control group (262.25±86.52) mm² vs. (768.54±168.65) mm²], with a statistical difference (t=-15.017, P<0.001). Conclusions　Both the advantage of cerebral artery lateralization and the high signal in the artery can indicate the establishment of collateral circulation after unilateral MCA M1 occlusion, but the high signal in the artery is more sensitive and accurate. The establishment of collateral circulation has positive significance for the selection of a treatment plan and for the patients' clinical prognosis.