海马梗死：三种新类型的鉴定。

Hippocampal infarction: Identification of three new types.

机构信息

Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, 68167 Mannheim, Germany.

出版信息

J Neuroradiol. 2018 Feb;45(1):1-5. doi: 10.1016/j.neurad.2017.08.003. Epub 2017 Sep 18.

DOI:10.1016/j.neurad.2017.08.003

PMID:28923531

Abstract

BACKGROUND AND PURPOSE

Hippocampal infarction (HI) is common but yet still not comprehensively studied. In the present study, we aimed to identify novel HI patterns and to describe additional ischemic lesions outside the hippocampus to draw conclusions regarding the underlying vessel occlusion.

METHODS

In 222 patients (mean age 69.9 (±13.6) years; 129 (58.1%) male, 93 (41.9%) female) with HI, diffusion-weighted images were analyzed with emphasis on HI patterns and associated ischemic lesions outside the hippocampus. HI were classified as type 1 (complete), 2 (lateral), 3 (dorsal), and 4 (circumscribed). Further possible HI patterns were defined and classified as type 5 (ventral), 6 (ventrolateral), and 7 (dorsolateral).

RESULTS

Unilateral HI was found in 218 (98.2%) patients. In these, type 5 and 6 were identified in 5 (2.3%) patients, and type 7 in 8 (3.7%) patients respectively. Type 1 was found in 62 (28.4%), 2 in 53 (24.3%), 3 in 57 (26.1%), and 4 in 28 (12.8%) patients. Further ischemic lesions were found in the territory of the anterior cerebral artery (3.6%), middle cerebral artery (14.9%), anterior choroidal artery (AChA) (7.2%), posterior cerebral artery (89.6%), and in the brainstem (6.3%) and cerebellum (20.3%). Type 5 and 6 were significantly associated with acute ischemic lesions in the AChA territory (6/10 (60%) vs. 11/200 (5.5%), P<0.001).

CONCLUSIONS

We identified three novel HI types. Probably, type 5 and 6 can be attributed to occlusion of the AChA. Overall, these HI types are rare, possibly due to a better collateralization in the case of AChA occlusion.

摘要

背景与目的

海马梗死（HI）较为常见，但尚未得到全面研究。本研究旨在确定新的 HI 类型，并描述海马外的其他缺血性病变，以得出关于潜在血管闭塞的结论。

方法

在 222 例 HI 患者（平均年龄 69.9（±13.6）岁；129 例男性，93 例女性）中，分析了弥散加权图像，重点分析 HI 类型和海马外的相关缺血性病变。HI 分为 1 型（完全型）、2 型（外侧型）、3 型（背侧型）和 4 型（局限型）。进一步定义并分类了可能的 HI 类型，分为 5 型（腹侧型）、6 型（腹外侧型）和 7 型（背外侧型）。

结果

单侧 HI 见于 218 例患者（98.2%）。其中，5 例（2.3%）患者存在 5 型和 6 型，8 例（3.7%）患者存在 7 型。62 例（28.4%）患者为 1 型，53 例（24.3%）患者为 2 型，57 例（26.1%）患者为 3 型，28 例（12.8%）患者为 4 型。在前大脑动脉（3.6%）、大脑中动脉（14.9%）、前脉络膜动脉（AChA）（7.2%）、后大脑动脉（89.6%）以及脑桥（6.3%）和小脑（20.3%）区域发现了进一步的缺血性病变。5 型和 6 型与 AChA 区域的急性缺血性病变显著相关（10/10（100%）vs. 200/200（10%），P<0.001）。