Essig M, von Kummer R, Egelhof T, Winter R, Sartor K
Department of Neuroradiology, University of Heidelberg, Germany.
AJNR Am J Neuroradiol. 1996 May;17(5):887-94.
To determine the significance of vascular enhancement in stroke patients with and without permanent neurologic deficit.
We prospectively studied two groups of patients with spin-echo MR imaging before and after injection of gadopentetate dimeglumine. In the patients in group 1 (12 women, 22 men; age range, 32 to 76 years), who had permanent neurologic deficit caused by recent ischemic brain infarction, we obtained 3 to 13 serial MR images during follow-up examination. Group 2 consisted of 26 patients (14 women, 12 men; age range, 54 to 81 years) with transient neurologic deficit caused by angiographically proved high-grade stenosis or occlusion of the internal carotid artery.
Vascular enhancement was present in 59% of patients in group 1 and in 65% of patients of group 2. In group 1, the frequency of vascular enhancement declined steadily over several weeks, but it was still present in single cases even after 3 months. Vascular enhancement correlated positively with the extent of brain infarction in group 1 and with the degree of carotid stenosis in group 2.
Vascular enhancement as shown by MR imaging may herald ischemic brain infarction and could persist over several weeks in areas that show collateral flow after infarction has occurred.
确定有无永久性神经功能缺损的中风患者血管强化的意义。
我们前瞻性地研究了两组在注射钆喷酸葡胺前后进行自旋回波磁共振成像的患者。在第1组患者（12名女性，22名男性；年龄范围32至76岁）中，他们因近期缺血性脑梗死导致永久性神经功能缺损，我们在随访检查期间获得了3至13个序列的磁共振图像。第2组由26名患者（14名女性，12名男性；年龄范围54至81岁）组成，他们因血管造影证实的颈内动脉高度狭窄或闭塞导致短暂性神经功能缺损。
第1组59%的患者和第2组65%的患者出现血管强化。在第1组中，血管强化的频率在几周内稳步下降，但即使在3个月后仍有个别病例存在。第1组中血管强化与脑梗死范围呈正相关，第2组中与颈动脉狭窄程度呈正相关。
磁共振成像显示的血管强化可能预示着缺血性脑梗死，并且在梗死发生后出现侧支循环的区域可能持续数周。
