大脑中动脉供血区梗伴脑皮质层状坏死MRI表现.docVIP

大脑中动脉供血区梗死伴脑皮质层状坏死MRI表现 　　[摘要] 目的 探讨大脑中动脉区脑梗死伴脑皮质层状坏死的MRI表现特点。方法 回顾性分析该院2015年8月―2017年5月临床随访证实的37例大脑中动脉区较大面积脑梗死伴脑皮质层状坏死的病例资料，重点分析其MRI表现特征。 结果 37例患者，均为单侧发病，MRA或CTA提示患侧大脑中动脉狭窄，其中重度狭窄21例，闭塞16例。MRI可见患侧大脑中动脉供血区较大片状梗死，其中较新鲜梗死2例，病灶呈T1WI低、T2WI及FLAIR高信号、DWI高信号、ADC低信号；陈旧性梗死35例，病灶呈T1WI低、T2WI高、FLAIR多低信号、DWI低信号、ADC高信号，伴患侧皮层弥漫性或局灶性萎缩。层状坏死均表现为沿梗死区皮质表面分布的线状或脑回样 T1WI高信号，部分高信号病灶可深达基底节区，MRI随访高信号多未见消失征象。结论 大脑中动脉区较大面积脑梗死伴脑皮质层状坏死多继发于大脑中动脉重度狭窄或闭塞，MRI及其随访可准确诊断。 中国论文网 /6/viewhtm　　[关键词] 大脑中动脉；脑梗死；脑动脉脑皮质层状坏死；磁共振成像 　　[中图分类号] R742 [文献标识码] A [文章编号] 1674-0742（2017）10（b）-0180-05 　　[Abstract] Objective This paper tries to investigate the MRI features of cerebral artery infarction with cerebral cortical laminar necrosis. Methods Among the 37 cases of follow-up from August 2015 to May 2017， patients of cerebral artery infarction with cerebral cortical laminar necrosis confirmed in this hospital were enrolled. The MRI performance features were mainly analyzed. Results All of the 37 cases were of unilateral onset， MRA or CTA showed stenosisin the ipsilateral cerebral artery， among which 21 cases were of severe stenosis， 16 cases were of occlusion. MRI showed a large infarction in the ipsilateral cerebral artery area； 2 cases were fresh infarction； MRI images showed that the infarction presenting as low signal in T1WI sequence， high signal in T2WI and FLAIR sequence， high signal in DWI sequence and low signal in ADC sequence； 35 cases of obsolete infarction； MRI showed that the infarction of low signal in T1WI sequence， high signal in T2WI， low signal in FLAIR sequence， low signal in DWI sequence and high signal in ADC sequence， with diffuse or localized cortical atrophy. The cerebral cortical necrosis presented itself as 1inear or gyrate high signal in T1WI， along the cortex surface or along the gyrus， some of the lesions could reach the region of basal ganglia. There was no disappearance sign of the high signal in the follow-up MRI. Conclusion The cerebral infarction combined with cerebral c