摘要
目的分析磁敏感加权成像（SWI）的磁敏感血管征（SVS）在探测急性大脑中动脉（MCA）血栓形成的价值及其与临床预后的相关性。方法回顾性分析2014年12月至2015年12月在郑州大学人民医院诊断为急性脑梗死的104例患者临床、影像学及实验室检查资料，采用Kappa分析比较MRA与SWI发现血栓的一致性；引用血栓负荷评分（CBS）综合分析血栓的程度和范围，并采用Spearman秩相关分析CBS与临床预后的相关性。结果104例急性脑梗死患者平均年龄60岁，女性占32％。SVS阳性患者39例（37．5％），SVS阳性且MRA相应血管闭塞或重度狭窄32例（30．8％），两者在预测急性脑梗死动脉血栓一致性较好（Kappa=0．502，P〈0．001）。SVS阳性MRA无狭窄6例，全部为远端。CBS与预后具有显著相关性（Spearman ρ=-0．472；P〈0．001）。结论SWI发现MCA远端动脉血栓较MRA敏感；高血栓负荷（较低CBS）可作为评估急性脑梗死患者预后较差的重要临床工具。
Objective To analysis the value of susceptibility vessel sign （SVS） in susceptibility weighted imaging （SWI） in detecting thrombogenesis in middle cerebral artery （MCA） and its association with clinical prognosis. Methods From December 2014 to December 2015 in People＇s Hospital of Zhengzhou University, we retrospectively examined clinical, imaging and experimental datafrom 104 consecutive patients with acute ischemic strokeand compared the consistency of detecting thrombus between SWI and magnetic resonance angiography （MRA） using Kappa analysis. Clot Burden Score （CBS） was used to analysis extent and scope of thrombus. The association between CBS and clinical prognosiswere analyzed by Spearman rank correlation. Results Mean age was 60 years old of the 104 patients with acute cerebral infarction and female accounted for 32%. There were 39 patients （ 37.5% ） with SVS positive in SWI and 32 patients （30. 8% ） with both SVS positive and MRA occlusion or severe stenosis. The consistency in predicting arterial thrombosis of occlusion or severe stenosis between MRA and SVS in SWI was statistically significant （ Kappa = 0. 502, P 〈 0. 001 ）. There were 6 eases with SVS positive and none stenosis in MRA, and all the clots in this 6 case were located in distal artery. CBS was significantly associated with 3-month outcome （Spearman ρ = -0. 472;P 〈 0. 001 ）. Conclusion SWI is superior to MRA for the detection of intracranial distal thrombus in patients with acute ischemic stroke of the MCA territory. Higher clot burden （lower CBS） could be an important clinical tool to estimate poor outcome in patients with acutecerebral infarction.
作者
黄月
梅文丽
刘慧勤
李永丽
陈祖芝
李冬冬
张杰文
Huang Yue Mei Wenli Liu Huiqin Li Yongli Chen Zuzhi Li Dongdong Zhang Jiewen(Department of Neurology, People＇ s Hospital of Zhengzhou University, Zhengzhou 450003, Chin)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第1期7-11,共5页
National Medical Journal of China
基金
河南省科技公关计划项目（162102310295）
河南省医学科技公关计划项目（201602179）
关键词
急性脑梗死
磁敏感加权成像
磁共振血管造影
磁敏感血管征
Acute ischemic stroke
Susceptibility weighted imaging
Magnetic resonance angiography
Susceptibility vessel sign
