Secondary signal change and an apparent diffusion coefficient decrease of the substantia nigra after striatal infarction.
Secondary signal change and an apparent diffusion coefficient decrease of the substantia nigra after striatal infarction.
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DOI：
10.1161/strokeaha.112.673020
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发表时间：
2013-01
期刊：
影响因子：
8.3
通讯作者：
Hirano T
中科院分区：
文献类型：
--
作者：
Nakajima M;Inatomi Y;Okigawa T;Yonehara T;Hirano T
弥散加权成像可以通过表观扩散系数(ADC)的降低来显示同侧纹状体脑梗塞患者黑质的继发性信号改变。这一现象的临床预测因素仍不清楚。我们评估了98例卒中患者，这些患者的急性缺血性损害位于基底节、外囊或内囊的一侧。分析随访MRI获得的双侧黑质的ADC值、各种临床因素和患者的预后。19名在3天内接受MRI随访的患者被排除在分析之外，因为他们都没有表现出明显的黑质ADC值变化。在79例患者中，21例(26.6%)黑质ADC值降低。苍白球的缺血性损害(优势比12.90)和栓塞性疾病的存在(优势比6.95)是黑质ADC值下降的独立预测因素。卒中起病3个月后，ADC降低的患者和无ADC降低的患者的临床结果没有差异。急性纹状体梗塞后，当苍白球受累或患者患有栓塞性疾病时，更常见的是黑质ADC的减少，然而，这并不一定与患者的临床结果有关。
Diffusion-weighted imaging can depict secondary signal change of the substantia nigra of patients with ipsilateral striatal infarction via a decrease in the apparent diffusion coefficient (ADC). Clinical predictors of this phenomenon remain unclear. We assessed 98 stroke patients with acute ischemic lesions in the hemilateral basal ganglia, external capsule, or internal capsule. The ADC values of the bilateral substantia nigra obtained from a follow-up MRI, various clinical factors, and patients’ outcome were analyzed. Nineteen patients who underwent a follow-up MRI within 3 days were excluded from analysis because none of them demonstrated a significant ADC change of substantia nigra. Of 79 patients, 21 (26.6%) revealed a decreased ADC in the substantia nigra. Ischemic lesions in the globus pallidus (odds ratio 12.90) and the presence of emboligenic diseases (odds ratio 6.95) were independent predictors for an ADC decrease in the substantia nigra. The clinical outcome 3 months after stroke onset was not different between patients with an ADC decrease and patients without. A reduction of ADC in the substantia nigra after acute striatal infarction was more frequently observed when the globus pallidus was affected or when the patient had emboligenic diseases, however, did not necessarily relate to the patient's clinical outcome.