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临床-弥散加权成像不匹配与进展性脑梗死的相关性研究

, PP. 419-423

Keywords: 进展性脑梗死,临床-弥散加权成像不匹配,大脑中动脉,梗死部位

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Abstract:

目的探讨临床-弥散加权成像不匹配(CDM)能否有效预测进展性脑梗死的发生,以指导临床诊断和治疗。方法收集发病24h内入院的脑梗死病人120例,根据NIHSS评分进行分组,分为进展组与非进展组,利用磁共振脑动脉成像(MRA)、磁共振弥散加权成像(DWI)及颈动脉彩超检查评价颈内动脉、大脑中动脉狭窄或闭塞及梗死部位,并根据NIHSS评分及Alberta卒中早期评分(ASPECTS)将每组患者分为CDM(+)及CDM(-)两亚组,分析临床-弥散加权成像不匹配(CDM)与进展性脑梗死的相关性。结果进展组中CDM(+)及MRA显示的大脑中动脉狭窄或闭塞发生率明显高于非进展组,差异有统计学意义(P<0.05);Logistic回归分析显示,CDM、大脑中动脉狭窄或闭塞是进展性脑梗死的独立危险预测指标;侧脑室体旁梗死或分水岭梗死是进展性脑梗死的常见类型。结论通过临床-弥散加权成像不匹配、MRA显示的大脑中动脉狭窄或闭塞及梗死部位能有效地预测进展性脑梗死的发生。

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