HVS联合ASPECTS评分在脑梗死临床预后的应用价值

发布时间：2018-05-16 10:27

本文选题：脑梗死 + T2　；参考：《青海大学》2017年硕士论文

【摘要】：目的:探讨T2 FLAIR序列血管高信号征(HVS)在大脑中动脉供血区梗死患者的影像表现及临床预后应用价值。方法:回顾性分析经头颅MRI检查的90例大脑中动脉供血区梗死伴相应临床表现的患者,分析比较远端HVS组与无远端HVS组高血压、高血脂等一般临床资料、ASPECTS评分应用和不同时期NIHSS评分之间的差异。同时间收集同一时期73例非脑梗死患者,观察HVS征像显示情况。结果:1、90例梗死患者中,远端HVS组48例,无远端HVS组42例,两组一般临床资料均无统计学差异(P0.05)。2、远端HVS组梗死脑叶范围低于无远端HVS组,分别为(2.292±1.383)、(2.881±1.234),两组差异有统计学意义(P0.05);DWI-ASPECTS中评分≤6分者前后两组分别占35.4%和71.4%,差异有统计学意义(P0.05)。3、远端HVS组患者入院时、10-14天NIHSS评分以及早期神经功能恢复分值均低于无远端HVS组,两组比较差异均有统计学意义(P0.05)。4、90例患者中77例行MRA检查,42例远端HVS组患者中,动脉闭塞者占71.4%、狭窄占28.6%,35例无远端HVS组患者中,动脉闭塞占37.1%、狭窄占40.0%、正常占22.9%;两组比较差异有统计学意义(P0.05)。5、73例非脑梗患者T2 FLAIR序列均未出现HVS征。结论:1、远端HVS征象可提示血管闭塞或严重狭窄;2、远端HVS征象可提示存在较好的侧支循环;3、HVS作为一种特殊的侧支循环评估方法,可作为判断患者预后指标之一。
[Abstract]:Objective: to investigate the imaging features and clinical prognostic value of T 2 FLAIR hyperintensity sign in patients with infarction in the middle cerebral artery (MCA). Methods: 90 patients with middle cerebral artery (MCAA) infarction with corresponding clinical manifestations were retrospectively analyzed by MRI, and hypertension was compared between distal HVS group and non-distal HVS group. General clinical data such as hyperlipidemia and the difference between the application of ASPECTS score and the NIHSS score at different stages. HVS signs were observed in 73 patients with non-cerebral infarction at the same time. Results there were 48 cases in distal HVS group and 42 cases in non-distal HVS group. There was no significant difference in general clinical data between the two groups (P < 0.05). The range of infarct lobes in distal HVS group was lower than that in non-distal HVS group. The difference between the two groups was statistically significant (P < 6). The difference between the two groups was 35.4% and 71.4%, respectively. The NIHSS score and the early recovery score of the distal HVS group were significantly lower than those of the non-distal HVS group on 10-14 days after admission, and the recovery score of early nerve function in the distal HVS group was significantly lower than that in the non-distal HVS group. The difference between the two groups was statistically significant in 77 patients with MRA and 42 patients with distal HVS. Among the 42 patients with distal HVS, 71.4 patients had arterial occlusion, and 28.6patients with stenosis had no distal HVS. Arterial occlusion was 37. 1%, stenosis was 40. 0% and normal was 22. 9.The difference between the two groups was statistically significant (P 0. 05). There was no HVS sign on T2 FLAIR sequence in 73 patients with non cerebral infarction. Conclusion the distal HVS signs may indicate occlusion or severe stenosis. The distal HVS signs can be used as a special method to evaluate collateral circulation, and can be used as a prognostic index in patients.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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