微创医学

【摘要】目的探讨不同病因的急性基底动脉闭塞在磁共振表现上的差异。方法回顾性分析28例急性基底动脉闭塞患者的临床及影像资料，并根据其不同的病因机制进行分组，分析各组患者在磁共振表现上的差异。结果 28例急性基底动脉闭塞患者，心源性栓塞患者6例，动脉粥样硬化性闭塞患者22例。动脉粥样硬化性闭塞组患者T1表现为均匀等信号14例，混杂信号8例；T2表现为混杂信号12例，均匀等信号10例。心源性栓塞组中，T1表现为均匀等信号5例，混杂信号1例，T2表现为均匀高信号4例，均匀等信号2例。两组患者在T1上信号表现无明显差异，在T2上心源性栓塞患者多表现为T2均匀高信号（P=0.001）；动脉粥样硬化性闭塞患者多表现为混杂信号（P=0.024）。结论磁共振对不同病因的急性基底动脉闭塞有一定的诊断价值，心源性栓塞以T2均匀高信号为主，动脉粥样硬化性闭塞以混杂信号为主。

Objective To explore the differences in MRI manifestations of acute basilar artery occlusion due to different pathogenesis. Methods We retrospectively analyzed the clinical and imaging data of 28 cases of acute basilar artery occlusion. And we divided the patients into two groups according to the pathogenesis, analyzed the differences in MRI. Results Of a total of 28 cases of patients with basilar artery occlusion, 22 cases were atherosclerotic occlusive patients, 6 patients were cardioembolism patients. In atherosclerotic occlusive group, 14 cases demonstrated homogeneous equal signal in T1, and 8 cases had mixed signal; and 12 cases had mixed signal in T2, 10 cases had homogeneous equal signal in T2. In cardioembolism group, 5 cases had homogeneous equal signal in T1, and 1 cases had mixed signal in T1; and 4 cases had homogeneous high signal in T2, 2 cases had homogeneous equal signal in T2. Two groups of patients showed no significant difference in T1. In T2, cardioembolism patients showed more homogeneous high signal (P=0.001); atherosclerotic occlusive patients showed more mixed signal (P=0.024). Conclusion MRI has of value in etiologic diagnosis of acute basilar artery occlusion. Cardioembolism mostly presents homogeneous high signal in T2, while atherosclerosis mostly shows mixed signal.