Department of Radiology, University Hospital of Saint Etienne, Saint-Priest-en-Jarez, France.
Stroke Unit, University Hospital of Saint Etienne, Saint-Priest-en-Jarez, France.
Sci Rep. 2020 Feb 3;10(1):1662. doi: 10.1038/s41598-020-58480-y.
Distinction between deep and superficial middle cerebral artery (MCA) territories and their junctional vascular area (the internal borderzone or IBZ) constitutes a predictor of stroke patient outcome. However, the IBZ boundaries are not well-defined because of substantial anatomical variance. Here, we built a statistical estimate of the IBZ and tested its vulnerability to ischemia using an independent sample. First, we used delineated lesions of 122 patients suffering of chronic ischemic stroke grouped in deep, superficial and territorial topographies and statistical comparisons to generate a probabilistic estimate of the IBZ. The IBZ extended from the insular cortex to the internal capsule and the anterior part of the caudate nucleus head. The IBZ showed the highest lesion frequencies (~30% on average across IBZ voxels) in our chronic stroke patients but also in an independent sample of 87 acute patients. Additionally, the most important apparent diffusion coefficient reductions (-6%), which reflect stroke severity, were situated within our IBZ estimate. The IBZ was most severely injured in case of a territorial infarction. Then, our results are in favour of an increased IBZ vulnerability to ischemia. Moreover, our probabilistic estimates of deep, superficial and IBZ regions can help the everyday spatial classification of lesions.
大脑中动脉（MCA）深、浅部分支及其交界区（内边界区或 IBZ）的区分是预测脑卒中患者预后的一个重要因素。然而，由于存在大量的解剖学差异，IBZ 的边界尚未得到明确界定。在这里，我们通过构建一个 IBZ 的统计估计值，并使用独立样本对其缺血易感性进行了测试。首先，我们使用了 122 名患有慢性缺血性脑卒中患者的病灶进行了划定，这些患者被分为深、浅和区域性三种类型，并进行了统计学比较，以生成 IBZ 的概率估计值。IBZ 从脑岛皮质延伸到内囊和尾状核头部的前部。在我们的慢性脑卒中患者中，IBZ 区域的病灶频率最高（IBZ 体素的平均频率约为 30%），而在 87 名急性脑卒中患者的独立样本中也发现了同样的结果。此外，反映脑卒中严重程度的表观扩散系数的最重要降低（平均为-6%）位于我们的 IBZ 估计值内。在区域性梗死的情况下，IBZ 区受到的损伤最为严重。因此，我们的结果支持 IBZ 区对缺血更为敏感。此外，我们对深、浅区和 IBZ 区的概率估计有助于对病灶进行日常的空间分类。
