一侧大脑中动脉高密度征在超急性脑梗死CT诊断中意义探析.docVIP

一侧大脑中动脉高密度征在超急性脑梗死CT诊断中意义探析【摘要】 目的 提高对单侧大脑中动脉高密度征(hyerdense middle cerebral artery sign ,HMCAS)的认识,探讨其在超急性期脑梗死CT诊断中的意义。方法 回顾分析16例单侧大脑中动脉高密度征的超急性期脑梗死患者,所有患者发病1~6 h内行CT扫描及发病后24 h后复查CT。结果 16例患者均发现有单侧大脑中动脉高密度征,24 h后复查CT,该侧大脑中动脉供血区均出现大片状低密度灶,其中7例大脑中动脉高密度征消失。结论 侧大脑中动脉高密度征(HMCAS),是CT诊断超级性脑梗死的重要征象。 【关键词】大脑中动脉;高密度征;脑梗死 Explore the significance of unilateral hyerdense middle cerebral artery sign(HMCAS) in the diagnosis of very early cerebral infarction with CT YANG Rong-fu,TIAN Zong-wu.Medical Imaging Department,The Fourth Hospital of Chang Sha,Hunan, Chang sha 410006,China 【Abstract】 Objective To explore the significance of unilateral HMCAS in the diagnosis of very early cerebral infarction with CT.Methods 16 cases that had very early cerebral infarction with unilateral HMCAS were analyzed retrospectively.Which were confirmed by clinical data.All cases were examined with CT within 1-6 hours after the onset of the disease, and CT scanning after 24 hours.Results The CT features of all cases were reviewed,It was found that unilateral HMCAS existed in the first CT scanning,all cases were followed-up by CT after 24 hours,A big area of low density in the region supplied by MCA was shown, Unilateral HMCAS displayed in 7 cases.Conclusion Unilateral HMCAS is an important feature in the diagnosis of very early cerebral infarction with CT. 【Key words】 Middle cerebral artery; High density sign; Cerebral infarction 大脑中动脉高密度征(hyerdense middle cerebral artery sign ,HMCAS)是大脑中动脉(middle cerebral artery ,MCA)主干闭塞的影像学征象,是MCA供血区大范围脑梗死的超早期表现。临床将起病后 2~3 d内的脑梗死归属于急性期脑梗死 ,临床从急性期中又分出超急性期 ,即起病后 6 h内的脑梗死属这一类。超急性脑梗死在发病12 h内此时脑实质未见明显低密度改变,但临床已有神经或肢体症状。有时患者发病后6 h内会发现单侧大脑中动脉水平段密度增高,即大脑中动脉高密度征(HMCAS )。本文报告16例病例并观察其动态变化,探讨CT对超急性期脑梗死的诊断意义,并提高对本病的临床及影像学认识。 1 资料与方法 1.1 一般资料 本文收集我院2003年7月至2009年10月期间,临床表现均有头痛、头昏及不同程度意识障碍及肢体感觉障碍,在发病6 h内做CT检查并在随后的CT复查中证实确有相应脑梗死病例,排除脑出血、脑干梗死、陈旧性脑梗死者共16例,男10例,女6例;年龄最大83岁,最小45岁,平均64岁。其中4例意识丧失及两便失禁;5例有不同程度肢体感觉障碍,6例肢体偏瘫。12例有高血压,2例冠心病及风心病。 1.2 检查方法 16例患者均采用Sie