Kinoshita Toshibumi, Ogawa Toshihide, Yoshida Yasuji, Tamura Hajime, Kado Hirotsugu, Okudera Toshio
Department of Radiology, Research Institute of Brain and Blood Vessels-Akita, Akita, Japan.
Neuroradiology. 2005 Sep;47(9):647-51. doi: 10.1007/s00234-005-1398-0. Epub 2005 Jul 19.
Curvilinear T1 hyperintense lesions in the cerebral cortex in patients with subacute infarction were investigated for: (1) the presence or absence of T2* hypointensity and (2) correlations with neuropathologic findings. Thirty-six consecutive patients with subacute to chronic embolic infarction, in whom curvilinear hyperintense lesions in the infarcted cortex were seen on T1-weighted images, underwent echo-planar gradient-echo (GRE-EPI) T2*-weighted imaging. GRE-EPI T2*-weighted imaging revealed no evidence of hemorrhage within the curvilinear T1 hyperintense lesions of the cerebral cortex in all of the patients. In 11 of the 36 patients, focal hypointense lesions were seen in the depth of infarcted gyri on GRE-EPI T2*-weighted images. In the remaining 25 patients, no T2* hypointensities were seen in the infarct zone. Pathological correlation was performed in a patient with middle cerebral artery infarction and curvilinear hyperintense lesions on postmortem T1-weighted images. In the autopsied brain, curvilinear T1 hyperintense lesions corresponded to necrosis of all the cortical layers on histological examination. These data suggest that curvilinear hyperintense lesions in the cerebral cortex on T1-weighted images during the subacute to chronic period of cerebral infarction may not represent hemorrhage.
对亚急性梗死患者大脑皮质中曲线状T1高信号病变进行了如下研究：（1）是否存在T2低信号；（2）与神经病理学发现的相关性。连续36例亚急性至慢性栓塞性梗死患者，其梗死皮质在T1加权图像上可见曲线状高信号病变，接受了回波平面梯度回波（GRE-EPI）T2加权成像。GRE-EPI T2加权成像显示，所有患者大脑皮质曲线状T1高信号病变内均无出血迹象。36例患者中有11例在GRE-EPI T2加权图像上梗死脑回深部可见局灶性低信号病变。其余25例患者梗死区内未见T2*低信号。对1例大脑中动脉梗死且死后T1加权图像上有曲线状高信号病变的患者进行了病理相关性研究。在尸检大脑中，曲线状T1高信号病变在组织学检查中对应于所有皮质层的坏死。这些数据表明，在脑梗死亚急性至慢性期，T1加权图像上大脑皮质的曲线状高信号病变可能并不代表出血。
