国家神经系统疾病临床医学研究中心数据管理与共享系统
Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Cortical Microinfarcts in Patients with Middle Cerebral Artery Stenosis
第一作者：Xinyi Leng
通讯作者：Liping Liu
基本信息
- 负责人：Xinyi Leng
- 数据来源： CICAS
- 论文编号：CICAS20150124
- 发表时间：2017-04-07
2017-04-07
已发表文章
发表杂志：J Stroke Cerebrovasc Dis
发表类型: Original Contributions
影响因子(IF): 1.598
PMID: 2017 Aug;26(8):1760-1765 Pubmed原文链接 全文下载
主要研究背景及目的
脑白质病变与脑小血管病的发生发展密切相关，但脑白质病变的发病机制目前尚不明确。既往有研究关于颅内外大动脉狭窄与脑白质严重程度的关系，但结果不一致。本研究拟通过测量MCA中重度狭窄患者的血流动力学指标（signal intensity ratio，SIR），研究MCA血流动力学受损与脑白质病变严重程度的关系。
方法
Patients with a recent non-cardioembolic ischemic stroke or transient ischemic attack and an atherosclerotic MCA-M1 stenosis were recruited. The severity of MCA stenosis was defined as moderate (50%-69%) or severe (70%-99% or focal flow void) on time-of-flight MR angiography (MRA). The distal to proximal signal intensity ratio (SIR) of MCA stenosis was measured on time-of-flight MRA to represent its hemodynamic significance. The presence of CMI(s) in the ipsilateral hemisphere was assessed on axial T1- or T2-weighted images and T2-weighted fluid-attenuated inversion-recovery images.
结论
Patients with stroke and intracranial stenosis had a high burden of CMI. Except for a history of dyslipidemia, the hemodynamic significance of the arterial stenosis may contribute to the presence of ipsilateral CMI(s) in these patients, which warrants further investigation in prospective, longitudinal studies.
主要结果
Overall, 86 patients (mean age: 62.8 years; 77.9% males) were analyzed, 66 (76.7%) and 20 (23.3%), respectively, having moderate and severe MCA-M1 stenoses. The median SIR was .91. Forty-five (52.3%) patients had ipsilateral CMI(s). Multivariate logistic regression showed a history of dyslipidemia (odds ratio [OR] = 6.83, P = .008), and an SIR lower than the median (OR = 4.73, P = .014) were independently associated with presence of CMI(s) in ipsilateral hemisphere to an MCA-M1 stenosis.