Ogawa T, Yoshida Y, Okudera T, Noguchi K, Kado H, Uemura K
Department of Radiology and Nuclear Medicine, Research Institute of Brain and Blood Vessels-Akita, Senshu-kubota-machi, Japan.
Radiology. 1997 Jul;204(1):255-62. doi: 10.1148/radiology.204.1.9205256.
To evaluate secondary degeneration of the ipsilateral thalamus after cerebral infarction in the middle cerebral artery (MCA) distribution by using magnetic resonance (MR) imaging.
Thirty patients (17 men, 13 women; aged 30-85 years) with embolic cerebral infarction in the MCA distribution underwent serial MR imaging 2 hours to 12 months after a stroke. In 23 of the 30 patients, the authors evaluated cerebral blood flow with single photon emission computed tomography (SPECT).
T2-weighted spin-echo images disclosed a hyperintense area in the ipsilateral thalamus in 14 patients (47%) 1-12 months after stroke. The hyperintense area was confined to the dorsomedial or anterior and dorsomedial nuclei of the thalamus in nine of the 14 patients; it extended from the dorsomedial or anterior and dorsomedial nuclei to the ventral lateral nucleus or pulvinar in the remaining five patients. Hypoperfusion of the ipsilateral thalamus was observed in 21 of the 23 patients who underwent SPECT. Twelve of the 21 patients also showed a hyperintense area in the ipsilateral thalamus on the MR images.
MR imaging is useful in evaluating secondary thalamic degeneration after cerebral infarction. In clinical practice, this secondary degeneration should not be mistaken for other lesions such as further cerebral infarction.
通过磁共振（MR）成像评估大脑中动脉（MCA）分布区脑梗死同侧丘脑的继发性变性。
30例（男17例，女13例；年龄30 - 85岁）MCA分布区栓塞性脑梗死患者在卒中后2小时至12个月接受了系列MR成像检查。30例患者中的23例，作者用单光子发射计算机断层扫描（SPECT）评估了脑血流量。
T2加权自旋回波图像显示，14例患者（47%）在卒中后1 - 12个月同侧丘脑出现高信号区。14例患者中的9例，高信号区局限于丘脑背内侧核或前核与背内侧核；其余5例患者，高信号区从背内侧核或前核与背内侧核延伸至腹外侧核或丘脑枕。23例接受SPECT检查的患者中，21例观察到同侧丘脑灌注不足。21例患者中的12例在MR图像上同侧丘脑也显示出高信号区。
MR成像有助于评估脑梗死后脑丘脑的继发性变性。在临床实践中，这种继发性变性不应被误诊为其他病变，如进一步的脑梗死。
