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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Cortical Microinfarcts in Patients with Middle Cerebral Artery Stenosis
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Cortical Microinfarcts in Patients with Middle Cerebral Artery Stenosis

机译：中脑动脉狭窄患者的皮质微脑梗死

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Background: Cortical microinfarcts (CMIs) have been correlated to cognitive decline and dementia. It was previously considered only visible on microscope, but was recently reported to be visible on 3.0 Tesla magnetic resonance imaging (MRI) and linked to presence of intracranial stenosis. We aimed to investigate CMIs on 3.0 Tesla MRI in patients with M1 middle cerebral artery (MCA-M1) stenosis. Methods: Patients with a recent non-cardioembolic ischemic stroke or transient ischemic attack and an atherosclerotic MCA-M1 stenosis were recruited. The severity of MCA stenosis was defined as moderate (50%-69%) or severe (70%-99% or focal flow void) on time-of-flight MR angiography (MRA). The distal to proximal signal intensity ratio (SIR) of MCA stenosis was measured on time-of-flight MRA to represent its hemodynamic significance. The presence of CMI(s) in the ipsilateral hemisphere was assessed on axial T1- or T2-weighted images and T2-weighted fluid-attenuated inversion-recovery images. Results: Overall, 86 patients (mean age: 62.8 years; 77.9% males) were analyzed, 66 (76.7%) and 20 (23.3%), respectively, having moderate and severe MCA-M1 stenoses. The median SIR was .91. Forty-five (52.3%) patients had ipsilateral CMI(s). Multivariate logistic regression showed a history of dyslipidemia (odds ratio [OR] = 6.83, P = .008), and an SIR lower than the median (OR = 4.73, P =. 014) were independently associated with presence of CMI(s) in ipsilateral hemisphere to an MCA-M1 stenosis. Conclusions: Patients with stroke and intracranial stenosis had a high burden of CMI. Except for a history of dyslipidemia, the hemodynamic significance of the arterial stenosis may contribute to the presence of ipsilateral CMI(s) in these patients, which warrants further investigation in prospective, longitudinal studies. (C) 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
机译：背景：皮质微内梗死（CMIS）与认知下降和痴呆有关。它以前仅考虑在显微镜上可见，但最近据报道，在3.0特斯拉磁共振成像（MRI）上可见并与颅内狭窄的存在相关。我们的目标是在M1中脑动脉（MCA-M1）狭窄患者中调查3.0特斯拉MRI的CMIS。方法：招募了近期非心绞线缺血性卒中或瞬时缺血性发作的患者及动脉粥样硬化MCA-M1狭窄。 MCA狭窄的严重程度定义为在飞行时间MR血管造影（MRA）的中等（50％-69％）或严重（70％-99％或焦流量）。在飞行时间MRA上测量MCA狭窄的远端信号强度比（SIR）以代表其血流动力学意义。在轴向T1或T2加权图像和T2加权流体衰减的反转恢复图像上评估同侧半球中的CMI（S）的存在。结果：总体上，86名患者（平均年龄：62.8岁; 77.9％的男性）分别分析，分别为66（76.7％）和20（23.3％），具有中度和严重的MCA-M1狭窄。中位先生是.91 .91。四十五（52.3％）患者有同侧CMI。多变量逻辑回归显示血脂血症的历史（差距[或] = 6.83，p = .008），并且SIR低于中值（或= 4.73，p =。014）与CMI的存在独立相关在同侧半球到MCA-M1狭窄。结论：中风和颅内狭窄的患者具有高度的CMI负担。除血脂血症的历史外，动脉狭窄的血流动力学意义可能有助于这些患者中的同侧CMI的存在，这是在预期，纵向研究中进一步调查。 （c）2017国家冲程协会。由elsevier Inc.保留所有权利发布。

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