SPS3 Coordinating Centre, Division of Neurology, University of British, Columbia, S169-2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada.
Stroke. 2013 Jan;44(1):213-6. doi: 10.1161/STROKEAHA.112.673020. Epub 2012 Nov 13.
Diffusion-weighted imaging can depict secondary signal change of the substantia nigra of patients with ipsilateral striatal infarction via a decrease in the apparent diffusion coefficient (ADC). Clinical predictors of this phenomenon remain unclear.
We assessed 98 stroke patients with acute ischemic lesions in the hemilateral basal ganglia, external capsule, or internal capsule. The ADC values of the bilateral substantia nigra obtained from a follow-up MRI, various clinical factors, and patients' outcome were analyzed. Nineteen patients who underwent a follow-up MRI within 3 days were excluded from analysis because none of them demonstrated a significant ADC change of substantia nigra.
Of 79 patients, 21 (26.6%) revealed a decreased ADC in the substantia nigra. Ischemic lesions in the globus pallidus (odds ratio 12.90) and the presence of emboligenic diseases (odds ratio 6.95) were independent predictors for an ADC decrease in the substantia nigra. The clinical outcome 3 months after stroke onset was not different between patients with an ADC decrease and patients without.
A reduction of ADC in the substantia nigra after acute striatal infarction was more frequently observed when the globus pallidus was affected or when the patient had emboligenic diseases, however, did not necessarily relate to the patient's clinical outcome.
通过表观扩散系数（ADC）的降低，扩散加权成像可以描绘出同侧纹状体梗死患者的黑质的继发性信号变化。这种现象的临床预测因素尚不清楚。
我们评估了 98 例急性缺血性病变位于大脑半侧基底节、外囊或内囊的中风患者。对双侧黑质的 ADC 值进行了评估，这些值来自于随访 MRI、各种临床因素和患者的预后。由于 19 例患者在 3 天内进行了随访 MRI，且他们的黑质 ADC 没有明显变化，因此未对其进行分析。
在 79 例患者中，21 例（26.6%）黑质 ADC 降低。苍白球的缺血性病变（优势比 12.90）和栓子源性疾病的存在（优势比 6.95）是黑质 ADC 降低的独立预测因素。发病后 3 个月的临床预后在黑质 ADC 降低的患者和无黑质 ADC 降低的患者之间没有差异。
当苍白球受累或患者存在栓子源性疾病时，急性纹状体梗死后黑质 ADC 的降低更为常见，但与患者的临床预后不一定相关。
