目的探讨不同病灶部位的影像学特征对进展性脑梗死的预测作用。方法收集2010年1月至2014年6月在合肥市第三人民医院神经内科住院的脑梗死患者,所有患者经头颅磁共振明确病灶部位,影像学分型分为:前循环皮质、基底节、放射冠和后循环梗死;再根据病情有无进展分为非进展性和进展性脑梗死。比较各影像学亚型脑梗死在非进展性和进展性脑梗死组间的分布差异,并分析梗死亚型与是否进展的相关性分析,然后进一步回归分析进展性脑梗死的危险因素。结果共150例患者入选,其中非进展性脑梗死99例,进展性脑梗死51例;其影像学分型中,发生在皮质为46例,放射冠25例,基底节47例,后循环32例。不同影像学亚型脑梗死在非进展性和进展性脑梗死组间分布存在显著差异(χ2=19.239,P=0.001),其中,进展性脑梗死发生在前循环皮质的几率显著高于非进展性脑梗死;前循环皮质梗死与是否进展性间的相关性分析,其R和P值分别为0.170、和0.026;进展性脑梗死危险因素的Logistic回归分析显示,梗死的影像学亚型与其有关(P=0.002),表现为前循环皮质梗死发生梗死进展的可能性较其它亚型显著增加,即使经年龄、血糖等相关因素校正后,此种趋势依然存在(P=0.014)。结论梗死部位与其是否进展密切相关,发生在前循环皮质的患者更容易出现病情进展。
Objective To investigate the role of imaging characteristics of cerebral infarction in different regions in predicting the progressive cerebral infarction(PCI).Methods Patients with cerebral infarction were selected in the Department of Neurology of Hefei third People's Hospital from January 2010 to June 2014. Brain MRI were examined the location of cerebral infarction. Patients were then classified into four groups accordingly: cortical infarction, basal ganglion infarction, coronaradiata infarction and posterior infarction. Patients were further divided into PCI group and non-PCI group according to their clinical manifestations. MRI imaging features and risk factors were analyzed and compared between PCI group and non-PCI group.Results A total of 150 patients with cerebral infarction were enrolled, including 99 cases of non-PCI and 51 cases of PCI. According to the Brain imaging classification, there were 46 cases of cortical infarction, 25 cases of coronaradiata infarction, 47 cases of basal ganglion infarction and 32 cases of posterior infarction.There were significant differences in subtype cerebral infarction between PCI group and non-PCI group(χ2=19.239,P=0.001). The percent of cortical infarction were significantly higher in PCI group compared to the non-PCI group. Cortical infarction was correlated to PCI and the value of R and P was 0.170 and 0.026, respectively. Logistic regression revealed that Imaging of subtypes of cerebral infarction was correlative with PCI(P=0.002). The frequency of progression was significantly increased in cortical infarction than in other subtypes of cerebral infarction(P=0.002). The trend was still significant even after adjustment for age and blood glucose,(P=0.014).Conclusion The location of cerebral infarction is closely correlated to PCI in which cortical infarction is more likely to develop PCI.