桥脑旁正中梗死临床及磁共振血管成像改变研究.docVIP

桥脑旁正中梗死临床及磁共振血管成像改变研究【摘要】 目的 研究桥脑旁正中梗死(PPI)的临床表现及影像改变。方法 研究94例于2008年3月至2009年5月在我科住院的桥脑旁正中梗死的临床表现、影像特点。结果 桥脑旁正中梗死是后循环常见的梗死, MR上可见梗死灶的内侧位于桥脑旁正中、呈类似直线;病灶达桥脑表面, 类似楔形, MRA显示出基底动脉轻-中度狭窄,临床上主要表现为病变对侧中枢性面瘫及轻中度肢体瘫痪, 常伴构音障碍、头晕、共济失调、偏身感觉障碍等。结论 桥脑旁正中梗死发病率比我们所认识到的更为常见,基底动脉主干MRA主要表现为轻-中度狭窄。 【关键词】 桥脑旁正中梗死;分支动脉粥样硬化病;磁共振 Analysis the changes of the clinical and magnetic resonance angiography in paramedian pontine infarcts CHEN Han-shui,TONG Sui-jun,MA Qi-lin. Department of Neurology, The First Hospital of Xiamen,Affiliated Hospital of Fujian Medical University, Xiamen 361003, China 【Abstract】 Objective To evaluate changes of the clinical manifestations and MRI radiographic features of Paramedianpontine infarcts. Methods 48cases ofPPI patient were involved in our study,whose clinical and manifestations and MRI radiographic features were evaluated between March 2008 and May2009.Results Paramedian pontine infarct was one of mostcommon infarcts in the posterior circulatory system. MRA showed edge-shaped lesions in the upper mild and lower pons extending to the paramedianpontine。The main clinical feature was hemi paresis, accompanied by dysarthria, vertigo, ataxia and hemiparethesia et al.Conclusion The Paramedian pontine infarct is more common than we have known. The feature of MRA in the basilar artery (BA) is mainly showed light - moderate stenosis. 【Key words】 Paramedian pontine infarct;Branch atheromatous disease;Magnetic resonance imagine 作者单位:361003福建医科大学附属厦门第一医院神经内科 本组资料收集了经核磁共振的DWI联合MRA 证实为桥脑旁正中梗死的病例94例,分析其临床表现、影像特点。 1 资料与方法 1.1 一般资料 所有收集的48例系2008年3月至2009年5月在本科住院的桥脑旁正中梗死患者,并定义为A组,并收集46例经MR证实的桥脑腔隙性梗死的病例作为对照组,定义为B组。所有病例均经过颅脑DWI证实系急性桥脑梗死,由神经内科专科医师询问病史及查体, 症状体征至少由2 名神经内科专科医师确认, 入院后常规检查三大常规、肝肾功能、血脂血糖、心电图、心脏超声等, 并进行卒中危险因素的追查, 项目包括高血压、糖尿病、高脂血症、心脏病、既往有否TIA发作或心脑血管疾病史,吸烟(10支/d 以上)、饮酒(白酒100 g/d 以上)及纤维蛋白原的测定(4 g/L 视为异常)。全部病例于发病48 h内行头部MRI检查,具体项目包括DWI,T1加权像,T2加权像,FLAIR,以及矢状位及MRA(TOF序列),仪器采用西门子3.0T 超导磁场,以DWI相评估梗死灶,MRA评估基底动脉血管狭窄情况。 1.2 诊断依据 所有旁正中梗死患者符合原靖幸[1] 20