磁敏感血栓征在急性缺血性脑卒中病人诊治中的意义

骆嵩; 屈洪党; 马博; 李理; 刘东亮; 许娟娟; 史佩佩; 孙植培

doi:10.13898/j.cnki.issn.1000-2200.2021.02.007

磁敏感血栓征在急性缺血性脑卒中病人诊治中的意义

Clinical application value of susceptibility vessel sign in patients with acute ischemic stroke

摘要

摘要:
目的探讨磁敏感加权成像上磁敏感血栓征（SVS）在急性脑梗死临床诊断和治疗中的意义。
方法对25例急性脑梗死病人入院5 d内完善常规MRI、DWI、SWI和MRA等相关检查。对SWI对颅内责任血管血栓定位进行统计分析，并对全部脑梗死病人入院时进行神经缺损程度评分，发病90 d后进行残障评分，判断磁敏感血栓征对病人临床预后是否具有指示意义。
结果25例病人中，发现17例病人（68%）在SWI上有沿着病变血管走形的SVS，且SVS阳性病人血管闭塞率高于阴性病人（P < 0.05）；对25位脑梗死病人发病90 d后随访发现，17例SVS阳性的病人有10例病人临床预后不良，而8例SVS阴性病人，仅有1例病人临床预后不良，SWI上的SVS阳性病人较阴性病人临床预后不良率高（P < 0.05）。
结论脑梗死急性期，SWI的SVS征可以提示颅内责任动脉内血栓，并能提示病人临床预后不良。

Abstract:
ObjectiveTo investigate the significance of magnetic sensitive weighted imaging(SVS)in the diagnosis and treatment of acute cerebral infarction.
MethodsThe routine detection of MRI, DWI, SWI and MRA in 25 patients with acute cerebral infarction were implemented.The location of intracranial responsible blood vessel thrombosis was analyzed using SWI, the nerve defect degree score on admission and disability score after 90 days of onset were performed in all cases, and the significance of magnetically sensitive thrombus sign in judging the prognosis of patients was analyzed.
ResultsAmong 25 patients with acute cerebral infarction, the SVS along lesion vessel in 17 cases(68%)were found in SWI, and the vascular occlusion rate in SVS-positive patients was higher than that in SVS-negative patients(P < 0.05).During the following-up for 90 days of 25 patients with cerebral infarction, the clinical prognosis in 10 cases with positive SVS, 8 cases with negative SVS and 1 case were poor, and the poor clinical prognosis rate of positive SVS patients in SWI was higher compared with negative SVS patients(P < 0.05).
ConclusionsDuring the acute phase of cerebral infarction, the SVS sign in SWI can indicate the intracranial responsible intra-arterial thrombosis, and poor clinical prognosis.

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