摘要
目的探讨分水岭梗死（watershed infarction，WSI）类型与脑血管狭窄的相关性。方法纳入经MRI和弥散加权成像确诊的WSI患者。采用彩色多普勒超声进行颈内动脉（internal carotid artery，ICA）颅外段检查，磁共振血管成像进行颅内血管检查。WSI患者分为皮质分水岭梗死（cortical watershed infarction，CWSI）、内分水岭梗死（internal watershed infarction，IWSI）和混合型分水岭梗死（mixed-type watershed infarction，MWSI），分析不同WSI类型与脑血管狭窄的相关性。结果共纳入120例WSI患者，CWSI18例，IWSI48例，MWSI54例。同侧血管狭窄：ICA48例（40．O％，其中颅外段22例、颅内段39例）、大脑前动脉24例（20．0％）、大脑中动脉（middle cerebral artery，MCA）86例（71．7％）、大脑后动脉40例（33．3％）、椎基底动脉35例（29．2％）、ICA＋MCA36例（30．0％）。不同类型WSI之间同侧ICA、MCA和ICA＋MCA狭窄检出率差异有统计学意义。多变量logistic回归分析显示，CWSI多伴发同侧ICA狭窄[优势比（oddsratio，OR）0．022，95％可信区间（confidence interval，CI）0．002-0．230；P=0．001]，IWSI多伴发同侧MCA狭窄（OR40．164，95％CI3．861～417．810；P=0．002），而MWSI多伴发同侧MCA狭窄（OR9．586，95％CI2．776～33．126；P〈0．001）和同侧ICA＋MCA狭窄（OR7．481，95％CI2．541-22．022；P〈0．001）。结论不同类型WSI之间同侧ICA、MCA和ICA＋MCA狭窄发生率存在显著差异。CWSI多伴发同侧ICA狭窄，IWSI多伴发同侧MCA狭窄，而MWSI多伴发同侧IcA＋MCA狭窄。
Objective To investigate the correlation between the cerebral watershed infarction （WSI） types and cerebrovascular stenosis. Methods Patients with WSI diagnosed by MRI and diffusion-weighted imaging were enrolled. Color Doppler ultrasound was used to conduct extracranial internal carotid artery （ICA） examination. Magnetic resonance angiography was used to conduct intracranial vascular examination. The patients with WSI were divided into cortical watershed infarction （CWSI）, internal watershed infarction （IWSI）, and mixed-type watershed infarction （MWSI）. The correlation between the different types of WSI and cerebral vascular stenosis were analyzed. Results A total of 120 patients with WSI were enrolled, including 18 with CWSI, 48 with IWSI, and 54 with MWSI. Ipsilateral vascular stenosis： 48 patients were in ICA （40. 0%, 22 of them in the extracranial segment, 39 in the intracranial segment）, 24 （20. 0% ） were in the anterior cerebral artery, 86 （71.7%） were in the middle cerebral artery, 40 （33.3%） were in the posterior cerebral artery, 35 （29.2%） were in the vertebral basilar artery, and 36 （30. 0% ） were in ICA ＋ MCA. There were significant differences in the detection rates of ipsilateral ICA, MCA and ICA ＋ MCA stenosis among different types of WSI. Multivariate logistic regression analysis showed that CWSI often accompanied by the ipsilateral ICA stenosis （odds ratio [ OR] O. 022; 95% confidence interval [ CI] 0. 002 -0.230; P =0. 001）; IWSI often accompanied by the MCA stenosis （OR 40. 164; 95% CI 3.861 - 417. 810; P =0. 002）, while MWSI often accompanied by the ipsilateral MCA stenosis （OR 9. 586; 95% CI 2. 776 - 33. 126; P 〈 0. 001 ） and ipsilateral ICA ＋ MCA stenoses （OR 7.481 ; 95 % CI 2.541 - 22. 022; P 〈 0. 001）. Conelnsion There were significant differences in the incidence of the ipsilateral ICA, MCA, and ICA ＋ MCA stenosis among the different types of WSI. CWSI often accompanied by the ipsilateral ICA stenosis, IWSI often accompanied by the ipsilateral MCA stenosis, and MWSI often accompanied by the ipsilateral ICA ＋ MCA stenosis.
出处
《国际脑血管病杂志》
2015年第12期887-892,共6页
International Journal of Cerebrovascular Diseases
关键词
脑梗死
颈动脉疾病
颅内动脉疾病
弥散磁共振成像
磁共振血管造影术
超声检查
多普勒
双功能
Cerebral Infarction
Carotid Artery Diseases
Intracranial Arterial Diseases
DiffusionMagnetic Resonance Imaging
Magnetic Resonance Angiography
Ultrasonography, Doppler, Duplex
