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目的:探讨脑卒中后锥体束继发性损害的常规磁共振(MRI)表现及意义。方法:连续性收录分析2007～2008年在我院住院治疗,首次发病,病程在7 d内,有单侧肢体偏瘫及中枢性面舌瘫等体征,分别在急性期(7 d)内及亚急性期(14 d)以后进行一次及以上头颅MRI检查,确诊为单侧基底节或放射冠区单一梗死灶或单一血肿的脑卒中患者的临床资料。结果:本组39例患者,其中脑出血13例,脑梗死26例,平均年龄(51.40±7.56)岁,均有肢体偏瘫的体征,并且在两次MRI检查之间神经功能逐渐恢复。所有患者第2次的MRI图像上,均在远离病灶的大脑脚、脑桥、延髓等一个或多个部位,相当于锥体束行程上出现大小不等、边缘不清的长T1短T2、或者长T1长T2的异常信号。结论:MRI可以检测到脑卒中后锥体束继发损害的现象,临床上注意脑卒中后病灶远端锥体束行程上出现异常信号,很可能就是其继发性损害表现,这对区分与新发脑梗死或炎症等其他病变有积极意义。
Objective: To investigate the performance and significance of conventional magnetic resonance imaging (MRI) of secondary damage of pyramidal tract after stroke. Methods: Continuously included analysis of hospitalized in our hospital from 2007 to 2008, the first onset, duration of 7 days, with unilateral limb hemiplegia and central facial paralysis and other signs, respectively, in the acute phase (7 d) and Asia Acute phase (14 d) after more than one head MRI examination, diagnosed as unilateral basal ganglia or radial single infarct or single stroke in patients with stroke clinical data. Results: In this group of 39 patients, there were 13 cases of intracerebral hemorrhage and 26 cases of cerebral infarction. The average age was (51.40 ± 7.56) years old, with signs of limb hemiplegia. The neurological function gradually recovered between two MRI examinations. The second MRI images of all patients were located at one or more sites far away from the brain, pons and medulla of the lesion, which corresponded to the appearance of long T1 short T2 with inconspicuous size on the pyramidal tract stroke, or Long T1 long T2 abnormal signal. CONCLUSION: MRI can detect the secondary damage of pyramidal tract after stroke. Clinically, attention should be given to the presence of abnormal signals in the distal pyramidal tract of stroke after the stroke, which is likely to be the result of its secondary damage. New cerebral infarction or inflammation and other diseases have a positive meaning.