进展性卒中与脑动脉狭窄的脑血管造影研究

目的探讨进展性脑梗死的影像学特点及与脑动脉狭窄之间的相关性。方法选择我院29例进展性脑梗死患者并与同期收治的31例完全性脑梗死患者比较,所有患者均行头颅MRI (或头颅CT)及脑血管造影检查(DSA检查),分析进展性脑梗死的影像特点及其与脑动脉狭窄的相关性。结果进展性脑梗死组分水岭脑硬死或侧脑室体旁梗死发生率72．4％(21／29)及脑动脉狭窄发生率75．86%(22／29)均明显高于完全性脑梗死组22．6％(7／31),35．48％(11／31)。进展性脑梗死组中重度狭窄发生率为55．17％(16／29),高于完全性脑硬死组的12．90%(4／31)。溃疡性斑块发生率在进展性脑梗死组48．28%(14／29)高于完全性脑梗死组16．13％(5／31)。结论中重度脑动脉狭窄及溃疡是进展性卒中的重要危险因素,应早期检查及处理脑动态狭窄以防止病情进展。

Brain angiographic analysis of deteriorating stroke and cerebral artery stenosis

Objective To observe the features of CT, MRI and DSA of deteriorating stroke and to investigate the correlation with cerebral artery stenosis. Methods Patients in our hospital were selected for the study, among which there were 29 deteriorating stroke patients and 31 complete stroke patients. All 60 patients were examined with CT/MRI and DSA.Analyze the correlation between the photographic features of deteriorating stroke and cerebral artery stenosis. Results Incidence of watershed infarction or paraventricular infarction was significantly higher in deteriorating stroke cases [72.4% (21/29)] than in complete stroke cases [22.6% (7/31)]. The same difference was observed in the incidence of cerebral artery stenosis [75.86% (22/29) vs 35.48% (11/31)]. Moderate-severe stenosis was observed more often in deteriorating stroke cases [55.17%(16/29)] than in complete stroke cases [12.90% (4/31)]. Significantly more ulcerating plaques were also observed in deteriorating stroke cases [48.28% (14/29)] than in complete stroke cases [16.13% (5/31)]. Conclusion Moderate-severe cerebral artery stenosis and ulceration may be major promoting factors of deteriorating stroke. Early examination and modification of the stenoses may prevent stroke from further deterioration.