Ogawa T, Okudera T, Inugami A, Noguchi K, Kado H, Yoshida Y, Uemura K
Department of Radiology and Nuclear Medicine, Research Institute of Brain and Blood Vessels-Akita, Akita City, Japan.
Radiology. 1997 Sep;204(3):847-51. doi: 10.1148/radiology.204.3.9280270.
To evaluate the degeneration of the ipsilateral substantia nigra after striatal infarction by using magnetic resonance (MR) imaging.
Twenty-five adult patients with embolic cerebral infarction of the middle cerebral artery distribution underwent MR imaging 0-4, 5-9, 12-15, and 27-29 days after the stroke. Sixteen of them also underwent follow-up MR imaging 2-12 months after the stroke.
Ten patients had an infarct in the striatum with or without a cortical infarct (striatal infarction group); the other 15 patients had an infarct in the cerebral cortex of the middle cerebral artery distribution without a striatal infarct (cortical infarction group). In all 10 patients with striatal infarction, a hyperintense spot appeared in the ipsilateral substantia nigra on T2-weighted fast spin-echo images 7-12 days after the onset. This area became less intense and smaller 3 months later. In the cortical infarction group, no hyperintense spot in the ipsilateral substantia nigra was observed at any time.
Degeneration of the substantia nigra ipsilateral to the striatal infarction was clearly demonstrated at MR imaging. This finding should not be mistaken for further cerebral infarction.
通过磁共振成像评估纹状体梗死同侧黑质的变性情况。
25例大脑中动脉分布区栓塞性脑梗死成年患者在卒中后0 - 4天、5 - 9天、12 - 15天以及27 - 29天接受磁共振成像检查。其中16例患者在卒中后2 - 12个月还接受了随访磁共振成像检查。
10例患者纹状体有梗死，伴或不伴有皮质梗死（纹状体梗死组）；另外15例患者大脑中动脉分布区的大脑皮质有梗死，无纹状体梗死（皮质梗死组）。在所有10例纹状体梗死患者中，发病7 - 12天后，T2加权快速自旋回波图像上同侧黑质出现高信号斑点。3个月后，该区域信号变弱且变小。在皮质梗死组，任何时候同侧黑质均未观察到高信号斑点。
磁共振成像清楚显示了纹状体梗死同侧黑质的变性。这一发现不应被误诊为进一步的脑梗死。
