Objective To investigate the correlation between the changes of middle cerebral artery ( MCA) wall and the severity of brain cerebral white matter hyperintensity ( WMH) and the risk factors associated with cerebral vascular dis-ease in patients who perform MRI image screening with acute cerebral infarction .Methods We collected 86 cases of pa-tients with acute ischemic stroke diagnosed by DWI and recorded patients medical history ,changes of MCA wall and the sig-nal level of cerebral white matter hyperintensity severity by means of MRI T 2 W,FLAIR and MCA in HRMRI .The risk fac-tors were analyzed according to MCA wall changes and WMH and the independent predictors of the two were analyzed by Logistic regression.Results Three cases of poor image quality were excluded ,and 83 cases were included in the study . There were 37 cases of significant WMH (2,3 points) in the T2FLAIR image,and 46 cases without significant WMH (0, 1).There was a significant correlation between WMH and age ,mRs score,hypertension,diabetes mellitus and MCA wall changes (P<0.05).Hypertension and MCA wall changes were significantly associated with WMH by Logistic regression . In this study,there were 38 cases of severe MCA wall changes (2,3 points) and 45 cases with no changes (0,1),and the difference with age , hypertension and diabetes was statistically significant .The Logistic regression showed that age was closely related to the severity of MCA wall changes in the brain .Conclusion WMH has a higher incidence in patients with cerebrovascular disease and is closely related to age ,mRs score,hypertension,diabetes and MCA wall changes .Early detection of MCA wall changes and take appropriate intervention measures for prevention of WMH has important clinical sig -nificance .%目的 对急性脑梗死患者进行头部MRI影像筛查,探讨大脑中动脉管壁改变与大脑白质高信号严重程度的相关性,以及脑血管病相关危险因素对它们的影响.方法 连续收集经DWI确诊的急性脑梗死患者86例,并应用头部MRI T2、FLAIR及大脑中动脉管壁HRMR成像,记录患者病史资料、大脑中动脉管壁改变情况及脑白质高信号程度.依据有无大脑中动脉管壁改变以及脑白质高信号严重程度分别分析两者危险因素,并采用多因素回归分析两者的独立预测因素.结果 排除3例图像质量不佳者,83例纳入研究.T2 FLAIR像中存在显著WMH(2分、3分)37例,不存在显著WMH(0分、1分)46例.WMH与年龄、mRs评分、高血压病、糖尿病及大脑中动脉粥样硬化管壁改变呈显著相关性(P<0.05).多因素回归分析中,高血压病、大脑中动脉粥样硬化管壁改变与WMH密切相关.本研究组中存在严重的大脑中动脉粥样硬化管壁改变(2分、3分)38例,不存在(0分、1分)45例,其与年龄、高血压病和糖尿病差异有统计学意义.多因素回归分析显示年龄与大脑中动脉粥样硬化管壁改变严重程度密切相关.结论 WMH在脑血管病患者中有较高的发病率,并与年龄、mRs评分、高血压病、糖尿病及高分辨下大脑中动脉粥样硬化管壁改变密切相关.早期发现大脑中动脉粥样硬化管壁改变并采取适当的干预措施,对于预防WMH具有重要临床意义.
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