Relation Between Cerebral Perfusion Territories and Location of Cerebral Infarcts
Relation Between Cerebral Perfusion Territories and Location of Cerebral Infarcts
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DOI：
10.1161/strokeaha.108.539866
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发表时间：
2009-05-01
期刊：
影响因子：
8.3
通讯作者：
Golay, Xavier
中科院分区：
文献类型：
--
作者：
Hendrikse, Jeroen;Petersen, Esben Thade;Golay, Xavier
背景和目的--脑供血动脉的灌注区在活体内很难评估，因此标准的脑灌注区模板经常被用来确定脑梗塞和供血血管之间的关系。在这项研究中，我们使用标准模板将这种脑梗塞分类与MRI上对脑灌注区域的个性化描述进行了比较。共有159例首次出现脑缺血临床症状的患者(男性92例，女性67例；平均年龄58.9岁)纳入研究。采用弥散加权成像技术显示脑缺血区域，用自旋标记磁共振成像技术显示左侧颈内动脉、右侧颈内动脉和椎基底动脉的血流灌注范围。结果：在92%的患者中，区域动脉自旋标记图像具有诊断质量。136名患者在弥散加权图像上显示了缺血区。来自区域动脉自旋标记图像的附加信息改变了11%的皮质或交界区梗塞的分类(6/56)，而在腔隙、脑室周围、小脑和脑干梗塞中没有观察到区域性的变化。结论--在卒中患者中，灌注区域成像提供的诊断信息对皮质和交界区梗塞的分类是有价值的，而对于其他类型的梗塞，没有观察到教科书分类的改变。(笔划。2009；40：1617-1622。)
Background and Purpose-The perfusion territories of the brain-feeding arteries are difficult to assess in vivo and therefore standard cerebral perfusion territory templates are often used to determine the relation between cerebral infarcts and the feeding vasculature. In the present study, we compared this infarct classification, using standard templates, with the individualized depiction of cerebral perfusion territories on MRI.Methods-The ethics committee of our institution approved the study protocol. A total of 159 patients (92 male, 67 female; mean age, 58.9 years) with first-time clinical symptoms of cerebral ischemia were included in the study. Diffusion-weighted imaging was used for depiction of the area of ischemia and the perfusion territories of the left internal carotid artery, right internal carotid artery, and vertebrobasilar arteries were visualized with territorial arterial spin labeling MRI. Infarct locations with respect to cerebral perfusion territories were evaluated with and without territorial arterial spin labeling MRI images.Results-In 92% of the patients, the territorial arterial spin labeling images were of diagnostic quality. One hundred thirty-six patients showed areas of ischemia on diffusion-weighted images. The additional information from the territorial arterial spin labeling images changed the classification in 11% of the cortical or border zone infarcts (6 of 56), whereas no territorial changes were observed in lacunar, periventricular, cerebellar, and brainstem infarcts.Conclusion-The diagnostic information provided by perfusion territory imaging in patients with stroke is valuable for the classification of cortical and border zone infarcts, whereas no change of the textbook-based classification was observed for other infarct types. (Stroke. 2009; 40: 1617-1622.)