Komiyama M, Nakajima H, Nishikawa M, Yasui T
Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan.
Neuroradiology. 1998 Dec;40(12):771-7. doi: 10.1007/s002340050682.
To examine the chronological changes characteristic of cortical laminar necrosis caused by brain infarction, 16 patients were repeatedly examined using T1-, T2-weighted spin-echo, T2*-weighted gradient echo, fluid attenuated inversion recovery (FLAIR) images, and contrast enhanced T1-weighted images at 1.0 or 1.5 T. High intensity cortical lesions were visible on the T1-weighted images from 2 weeks after ictus and became prominent at 1 to 3 months, then became less apparent, but occasionally remained at high intensity for 2 years. High intensity cortical lesions on FLAIR images became prominent from 1 month, and then became less prominent from 1 year, but occasionally remained at high intensity for 2 years. Subcortical lesions did not display high intensity on T1-weighted images at any stage. On FLAIR images, subcortical lesions initially showed slightly high intensity and then low intensity from 6 months due to encephalomalacia. Cortical lesions showed prominent contrast enhancement from 2 weeks to 3 months, but subcortical lesions were prominent from 2 weeks only up to 1 month. T2*-weighted images disclosed haemosiderin in 3 of 7 patients, but there was no correlation with cortical short T1 lesions. Cortical laminar necrosis showed characteristic chronological signal changes on T1-weighted images and FLAIR images. Cortical short T1 lesions were found not to be caused by haemorrhagic infarction.
为研究脑梗死所致皮质层状坏死的时间变化特征，对16例患者采用1.0或1.5T的T1加权自旋回波、T2加权自旋回波、T2加权梯度回波、液体衰减反转恢复（FLAIR）图像以及增强T1加权图像进行反复检查。发病2周后，T1加权图像上可见高强度皮质病变，1至3个月时病变明显，随后逐渐不明显，但偶尔在2年内仍保持高强度。FLAIR图像上的高强度皮质病变在1个月时开始明显，1年后逐渐不明显，但偶尔在2年内仍保持高强度。皮质下病变在任何阶段的T1加权图像上均未显示高强度。在FLAIR图像上，皮质下病变最初显示轻度高强度，6个月后由于脑软化而显示低强度。皮质病变在2周内至3个月时显示明显的对比增强，但皮质下病变仅在2周内至1个月时明显。7例患者中有3例在T2加权图像上显示含铁血黄素，但与皮质短T1病变无相关性。皮质层状坏死在T1加权图像和FLAIR图像上显示出特征性的时间信号变化。发现皮质短T1病变并非由出血性梗死引起。
