影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (6): 1396-1401.DOI: 10.7517/issn.1674-0475.220619

• 综述与论文 • 上一篇    下一篇

基于SWI的CMBs、ACVS特征与急性脑梗死患者预后的关系

陈翩翩, 王耀光, 申春云, 蔡林江, 陈少群, 陈洪恩, 高俊杰   

  1. 湛江中心人民医院神经内二科, 广东 湛江 524000
  • 收稿日期:2022-06-25 出版日期:2022-11-23 发布日期:2022-11-15
  • 通讯作者: 高俊杰

The Relationship between the Characteristics of CMBs and ACVS Based on SWI and the Prognosis of Patients with Acute Cerebral Infarction

CHEN Pianpian, WANG Yaoguang, SHEN Chunyun, CAI Linjiang, CHEN Shaoqun, CHEN Hongen, GAO Junjie   

  1. The Second Department of Neurology, Central People's Hospital of Zhanjiang, Zhanjiang 524000, Guangdong, P. R. China
  • Received:2022-06-25 Online:2022-11-23 Published:2022-11-15

摘要: 本研究探讨磁敏感加权成像(SWI)检出的脑微出血(CMBs)、不对称皮层静脉征(ACVS)与急性脑梗死(ACI)患者预后的关系。选取确诊为ACI并且接受静脉溶栓治疗的87例患者作为研究对象,所有研究对象均接受SWI扫描,按照改良Rankin量表(mRS),将患者分为预后良好(良好组58例)和预后不良(不良组29例)两组,对比两组的CMBs、ACVS的检出率,运用受试者操作特征(ROC)曲线方法探讨两项指标在预测ACI静脉溶栓治疗后患者的预后结局方面的作用。结果显示,良好组的CMBs、ACVS检出率显著低于不良组(P<0.05);Logistic模型结果显示,基线NIHSS评分越高、溶栓24hNIHSS评分越高、合并高血压、大脑中动脉重度狭窄、发生CMBs和ACVS,均是ACI患者不良预后的独立危险因素(P<0.05),ASPECTS梗死病灶面积评分降低是ACI患者不良预后的独立危险因素(P<0.05)。SWI可早期发现ACI患者静脉溶栓后的CMBs、ACVS特征,可评估患者不良预后的风险。

关键词: 磁共振, 磁敏感加权成像, 脑微出血, 不对称皮层静脉征, 急性脑梗死, 预后

Abstract: This study investigated the relationship between cerebral microbleeds (CMBs) and asymmetric cortical vein sign (ACVS) detected by susceptibility-weighted imaging (SWI) and the prognosis of patients with acute cerebral infarction (ACI). A total of 87 patients diagnosed with ACI and receiving intravenous thrombolysis were selected as the research subjects. All subjects underwent SWI scanning. According to the modified Rankin scale (mRS), the patients were divided into good prognosis (58 cases in the good group), poor prognosis (29 cases in the poor group) two groups. The detection rates of CMBs and ACVS were compared between the two groups, and the receiver operating characteristic (ROC) curve method was used to explore the prediction of the two indicators in the prognosis of patients after ACI intravenous thrombolysis. aspects of the role. The results showed that the detection rate of CMBs and ACVS in the good group was significantly lower than that in the poor group (P<0.05). Logistic model results showed that higher baseline NIHSS score, higher NIHSS score at 24 h of thrombolysis, combined hypertension, severe middle cerebral artery stenosis, CMBs, and ACVS were independent risk factors for poor prognosis in ACI patients (P<0.05). Decreased ASPECTS infarct area score was an independent risk factor for poor prognosis in ACI patients (P<0.05). SWI can early detect the characteristics of CMBs and ACVS after intravenous thrombolysis in ACI patients, and can evaluate the risk of poor prognosis of patients.

Key words: magnetic resonance, susceptibility weighted imaging, cerebral microhemorrhage, asymmetric cortical venous sign, acute cerebral infarction, prognosis