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目的:分析大脑中动脉供血区(MCA)急性脑梗死患者的磁敏感加权成像(SWI),探讨梗死侧侧脑室旁深部髓质静脉(DMV)数量与脑血管反应性(CVR)的相关性。方法:回顾性纳入首次发生患侧MCA供血区卒中患者109例,并已完成TCD CO_2负荷实验和SWI等检查。根据SWI图像将DMV数量分为3级,<5条为1级;5-10条为2级;>10条为3级,分析DMV分级与CVR的关系。结果:根据排除标准共纳入MCA供血区急性脑梗死患者53例,DMV 1级、2级和3级分别有29、18、6例患者,MCA平均CVR为0.40±0.18。DMV 1级CVR为(0.45±0.22)、2级为(0.35±0.15)和3级为(0.20±0.11),3组患者间CVR存在明显差异(P<0.05),且DMV 3级组较DMV 1级组、2级组显著降低(P<0.05);Spearman相关分析表明,DMV分级与CVR间存在明显的负性相关关系(P<0.001)。结论:MCA供血区脑梗死患者DMV分级与患侧MCA CVR呈负相关关系。
Objective: To analyze the magnetic resonance weighted imaging (SWI) in patients with acute cerebral infarction (MCA) and explore the relationship between the number of medullary deep medullary veins (DMV) and cerebrovascular reactivity (CVR) in the middle cerebral artery. Methods: A total of 109 patients with stroke in the affected side of MCA were retrospectively enrolled. TCD CO_2 load test and SWI were completed. According to the SWI images, the number of DMVs was divided into 3 levels, <5 for level 1; 5-10 for level 2;> 10 for level 3, to analyze the relationship between DMV classification and CVR. RESULTS: According to the exclusion criteria, 53 patients with acute cerebral infarction were included in the MCA blood supply area. There were 29, 18 and 6 patients with DMV grade 1, 2 and 3 respectively. The mean CVR of MCA was 0.40 ± 0.18. The level of CVR in grade 1 was (0.45 ± 0.22), the level 2 was (0.35 ± 0.15) and the level 3 was (0.20 ± 0.11). There was a significant difference in CVR between the 3 groups (P <0.05) (P <0.05). Spearman correlation analysis showed that there was a significant negative correlation between DMV classification and CVR (P <0.001). Conclusion: There is a negative correlation between DMV classification and MCVA CVR in MCA infarction patients.