Nabatame H, Nakamura K, Matsuda M, Fujimoto N, Fukuyama H
Department of Neurology, Medical Center, Shiga, Japan.
Rinsho Shinkeigaku. 1995 Jul;35(7):738-43.
We performed MRI and measured cerebral blood flow (CBF) using 123I-IMP SPECT microsphere model in twenty three right-handed patients with lacunar infarction. Twelve of 23 patients showed chronic deterioration of dysarthria and gait disturbance. The mental function of the patients was evaluated by the Mini-Mental State (MMS) examination. The area of high intensity on T2-weighted images was quantitatively analyzed in the cerebral white matter (WM), lenticular nucleus (LN) and thalamus (THA). The score of MMS was positively correlated with the local CBF in the bilateral frontal, parietal, temporal and occipital cortices (p < 0.05). Also, the area of high intensity in the left THA showed a significant negative correlation with local CBF of the bilateral frontal, parietal, temporal and occipital cortices (p < 0.001). The high intensity areas of the bilateral LN, right WM and right THA had a significant but weaker negative correlation with local CBF of some cortices. These findings suggest that thalamic lesions on the dominant side play an important role in the reduction of cortical blood flow and the deterioration of mental functions in patients with lacunar infarction.
我们对23例右利手腔隙性脑梗死患者进行了磁共振成像(MRI)检查,并使用123I-异碘安非他明(IMP)单光子发射计算机断层扫描(SPECT)微球模型测量了脑血流量(CBF)。23例患者中有12例出现构音障碍和步态障碍的慢性恶化。通过简易精神状态检查表(MMS)评估患者的精神功能。对脑白质(WM)、豆状核(LN)和丘脑(THA)的T2加权图像上的高强度区域进行了定量分析。MMS评分与双侧额叶、顶叶、颞叶和枕叶皮质的局部CBF呈正相关(p<0.05)。此外,左侧THA的高强度区域与双侧额叶、顶叶、颞叶和枕叶皮质的局部CBF呈显著负相关(p<0.001)。双侧LN、右侧WM和右侧THA的高强度区域与部分皮质的局部CBF呈显著但较弱的负相关。这些发现表明,优势侧丘脑病变在腔隙性脑梗死患者的皮质血流减少和精神功能恶化中起重要作用。