急性脑梗死大脑皮、髓静脉的磁敏感加权成像解剖研究

doi:10.13418/j.issn.1001-165x.2018.02.007

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (2): 153-157.doi: 10.13418/j.issn.1001-165x.2018.02.007

急性脑梗死大脑皮、髓静脉的磁敏感加权成像解剖研究

张小芬¹，　闻彩云²，　李建策²，　陈小莉³，　陈争珍⁴，　陈成春⁴

1.嘉兴学院医学院人体解剖学教研室，浙江嘉兴 314000； 2.温州医科大学附属第一医院MRI室，浙江温州 325003；
3.温州市人民医院康复科，浙江温州 325000； 4.温州医科大学人体解剖学教研室，浙江温州 325035

收稿日期:2018-01-08 出版日期:2018-03-25 发布日期:2018-05-04
通讯作者: 陈成春，教授，E-mail: cccwzmc@126.com
作者简介:张小芬（1989-），助教，医学硕士，主要从事脑静脉断层影像解剖研究，Tel: 13736432610， E-mail: jxxfzhang@126.com
基金资助:
国家自然科学基金项目（31671250）；浙江省教育厅科研项目（Y201636616）；温州市科技局项目 (Y20160469)

The anatomic study of cerebral cortical and medullary veins on susceptibility-weighted imaging in acute ischemic stroke

ZHANG Xiao-fen¹, WEN Cai-yun², LI Jian-ce², CHEN Xiao-li ³, CHEN Zheng-zhen⁴, CHEN Cheng-chun ⁴

1.Department of Anatomy of Jiaxing Medical University, Jiaxing 314000，Zhejiang Province，China; 2. Department of MRI, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325003，Zhejiang Province，China；3. Department of Rehabilitation, Wenzhou People’s Hospital, Wenzhou 325000，Zhejiang Province，China；4. Department of Anatomy of Wenzhou Medical University, Wenzhou 325035， Zhejiang Province，China

Received:2018-01-08 Online:2018-03-25 Published:2018-05-04

摘要/Abstract

摘要：

目的　利用磁敏感加权成像(susceptibility weighted imaging, SWI)技术分析脑梗死患者大脑皮、髓质静脉的不对称征与脑梗死严重度和梗死灶解剖学特征的相关性，为临床急性脑梗死诊断、治疗提供影像参考。方法　选取38例超急性期、62例急性期脑梗死患者，采用磁共振扫描，比较静脉不对称组与对称组的脑梗死严重度差异以及梗死灶解剖学特征差异。结果对于超急性期，静脉不对称组与对称组NIHSS评分分别为8（4~8.8）、5.5（3~8），两组评分无显著性差异（P=0.058）。对于急性期，静脉不对称组与对称组NIHSS评分分别为5（2~7）、1.5（1~2），两组评分有显著性差异（P=0.043）。大脑前循环和后循环动脉梗塞静脉不对称出现率分别为48(82.8%)、 12(28.6%)，两者有显著性差异（P<0.001）。结论急性期脑梗死的静脉不对称征可反映卒中更高的严重度，而超急性期则不然。大脑前循环梗塞更趋向于形成静脉不对称征。

关键词: , 磁敏感加权成像, 　急性脑梗死, 　静脉, 　最小密度投影

Abstract:

Objective　To assess the features of the cortical and medullary veins on the susceptibility weighted imaging（SWI） in patients with hyperacute and acute ischemic stroke and its relationship with stroke severity and the anatomical characteristics of the infarctions to provide the clinical diagnosis information and treatment related reference and guidance for patients with stroke. Methods We selected 38 stroke patients hyperacute ischemic and 62 patients with acute ischemic stroke. The examinations were conducted using MRI. The stroke severity and anatomy of infracts were assessed.　Results　The NIHSS score was 8（4~8.8）in PAVS（+） and 5.5（3~8）in PAVS（-） for hyperacute ischemic stroke (P=0.058). The NIHSS score was 5 (2~7) in PAVS（+） and 1.5 (1~2) in PAVS（-） for acute stroke (P=0.043). The frequency of PAVS was 82.8% in the anterior circulation ischemic stroke and 28.6% in the posterior circulation ischemic stroke (P<0.001). Conclusion　The appearance of PAVS represents poorer stroke severity in the acute ischemic stroke, except for the hyperacute ischemic stroke. The anterior circulation acute stroke tends to represent PAVS.

Key words: Susceptibility-weighted imaging, 　Acute ischemic stroke, 　Veins, 　Minimum intensity projections (mIPs)

张小芬,闻彩云,李建策,陈小莉,陈争珍,陈成春. 急性脑梗死大脑皮、髓静脉的磁敏感加权成像解剖研究[J]. 中国临床解剖学杂志, 2018, 36(2): 153-157.

ZHANG Xiao-fen, WEN Cai-Yun, LI Jian-Ce, CHEN Xiao-Li, CHEN Zheng-Zhen, CHEN Cheng-Chun. The anatomic study of cerebral cortical and medullary veins on susceptibility-weighted imaging in acute ischemic stroke[J]. Chinese Journal Of Clinical Anatomy, 2018, 36(2): 153-157.

参考文献

[1] Haacke EM, Mittal S, Wu Z, et al. Susceptibility-weighted imaging: technical aspects and clinical applications, part 1[J]. AJNR AM J Neuroradiol, 2009, 30(1): 19-30.
[2] Meoded A, Poretti A, Benson JE, et al. Evaluation of the ischemic penumbra focusing on the venous drainage: the role of susceptibility weighted imaging (SWI) in pediatric ischemic cerebral stroke[J]. J Neuroradiol, 2014, 41(2): 108-116.
[3] Polan RM, Poretti A，Huisman TA, et al. Susceptibility-weighted imaging in pediatric arterial ischemic stroke: a valuable alternative for the noninvasive evaluation of altered cerebral hemodynamics[J]. AJNR AM J Neuroradiol, 2015, 36(4): 783-788.
[4] Lou M, Chen Z, Wan J, et al. Susceptibility-diffusion mismatch predicts thrombolytic outcomes: a retrospective cohort study[J]. AJNR AM J Neuroradiol, 2014, 35(11): 2061-2067.
[5] Naik D, Viswamitra S, Kumar AA, et al. Susceptibility weighted magnetic resonance imaging of brain: a multifaceted powerful sequence that adds to understanding of acute stroke[J]. Ann Indian Acad Neurol, 2014, 17(1): 58-61.
[6] Baik SK, Choi W, Oh SJ，et al. Change in cortical vessel signs on susceptibility-weighted images after full recanalization in hyperacute ischemic stroke[J]. Cerebrovasc Dis , 2012, 34(3): 206-212.
[7] Mucke J, Möhlenbruch M, Kickingereder P, et al. Asymmetry of deep medullary veins on susceptibility weighted mri in patients with acute mca stroke is associated with poor outcome[J]. PloS one, 2015, 10(4): e0120801.
[8] Chen CY, Chen CI, Tsai FY, et al. Prominent vessel sign on susceptibility-weighted imaging in acute stroke: prediction of infarct growth and clinical outcome[J]. PloS one, 2015,10(6): e0131118.
[9] Jensen-Kondering U, Böhm R. Asymmetrically hypointense veins on t2*w imaging and susceptibility-weighted imaging in ischemic stroke[J]. World J Radiol, 2013, 5(4): 156-165.
[10]Santhosh K, Kesavadas C, Thomas B, et al. Susceptibility weighted imaging: a new tool in magnetic resonance imaging of stroke[J]. Clin Radiol, 2009, 64(1): 74-83.
[11]An H, Liu Q, Chen Y, et al. Oxygen metabolism in ischemic stroke using magnetic resonance imaging[J]. Transl Stroke Res, 2012, 3(1): 65-75.
[12]Huang P, Chen CH, Lin WC, et al. Clinical applications of susceptibility weighted imaging in patients with major stroke[J]. J Neurol, 2012, 259(7): 1426-1432.
[13]Park MG, Yang TI, Oh SJ, et al. Multiple hypointense vessels on susceptibility-weighted imaging in acute ischemic stroke: surrogate marker of oxygen extraction fraction in penumbra?[J]. Cerebrovasc Dis, 2014, 38(4): 254-261.
[14] An H, Ford AL, Vo KD, et al. Imaging oxygen metabolism in acute stroke using mri[J]. Curr Radiol Rep, 2014, 2(3): 39.

[1]	江剑宏, 段仁鹏, 李晓锋. 国人胆道三维重建解剖变异应用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 1-4.
[2]	郭红志, 王瑜, 张加琪, 梁海彬, 马梓玮, 冯伟, 吴忧, 司子燚. 血管铸型结合CT三维模型评估先兆子痫胎盘血管结构[J]. 中国临床解剖学杂志, 2024, 42(1): 5-10.
[3]	李佳伟, 张静, 李灿然, 兰文杰, 籍庆余, 郭志勇, 张云凤, 刘启, 陈清威, 李筱贺. 蒙古族人群股骨近端解剖参数X线测量[J]. 中国临床解剖学杂志, 2024, 42(1): 11-16.
[4]	李琨, 张燕, 郭冉, 郝咪咪, 吴轩宇, 徐艺芳, 王超群, 马文童, 张灵淇, 杨宏宇, 李志军, 张少杰, 王星. 儿童及青少年枕颈角与后枕颈角数字化测量及其临床意义[J]. 中国临床解剖学杂志, 2024, 42(1): 17-20.
[5]	李文, 杨思艺, 黄蕾, 卿霁雯, 蒋松涛, 张磊. 基于MRI探讨Lisfranc韧带的形态学特点及临床意义[J]. 中国临床解剖学杂志, 2024, 42(1): 21-25.
[6]	李凡凡, 徐阳, 王晓旭. 紫草素调节Nrf2/HO-1信号通路对实验性大鼠肉芽肿性小叶性乳腺炎的治疗作用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 26-32.
[7]	王兴航, 丁佳媛, 李放, 包翠芬, 阎丽菁. 人参皂苷Rg1通过抑制NLRP3炎症小体途径减轻氧糖剥夺/复供后小胶质细胞炎症反应[J]. 中国临床解剖学杂志, 2024, 42(1): 33-41.
[8]	程莹莹, 武建军, 蔡海燕, 焦旭文, 马江波, 丁银秀. 体外炎性诱导星形胶质细胞激活及功能分析[J]. 中国临床解剖学杂志, 2024, 42(1): 42-46.
[9]	祁志, 杨力, 贾秋叶, 陈浩伦, 段兆达, 吴春云. 依达拉奉经MAPKs通路对脂多糖激活的小胶质细胞Sirt3表达调控[J]. 中国临床解剖学杂志, 2024, 42(1): 47-53.
[10]	张晶晶, 王洪新. 黄芩苷通过PDGF/P38 MAPK信号通路对肺动脉高压大鼠的保护作用[J]. 中国临床解剖学杂志, 2024, 42(1): 54-58.
[11]	乐钦, 陈荣丽, 熊婧熙, 王婷怡, 蔡志恒, 易秋实, 曾心怡. 白芨多糖对大鼠跨区皮瓣choke区的影响[J]. 中国临床解剖学杂志, 2024, 42(1): 59-64.
[12]	李笑予, 张磊, 付磊, 李东波, 汪国友. 三步接骨法治疗Sanders Ⅱ型跟骨骨折的有限元研究[J]. 中国临床解剖学杂志, 2024, 42(1): 65-70.
[13]	吴研飞, 马剑雄, 卢斌, 王颖, 柏豪豪, 靳洪震, 马信龙. CT后处理技术重建CT值与终板抗压强度的相关性研究[J]. 中国临床解剖学杂志, 2024, 42(1): 71-76.
[14]	庄万强, 唐毅, 骆勇刚, 张辉. 关节镜联合胫骨高位截骨术对髌骨位置及髌股关节功能影响的早中期回顾性研究[J]. 中国临床解剖学杂志, 2024, 42(1): 77-82.
[15]	罗鹰, 窦伟誉, 吴小杭, 陈璟昆, 彭昌贵, 潘剑英 . 微创海马钢板内固定治疗跟骨骨折并发症的影响因素[J]. 中国临床解剖学杂志, 2024, 42(1): 83-88.

急性脑梗死大脑皮、髓静脉的磁敏感加权成像解剖研究

The anatomic study of cerebral cortical and medullary veins on susceptibility-weighted imaging in acute ischemic stroke

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0