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目的探讨大脑中动脉高密度征(HMCAS)在大脑中动脉(MCA)供血区超急性期梗死的诊断价值。方法对46例MCA供血区超急性期脑梗死(发病6h内)的CT征象及临床表现进行分析,并定期复查CT观察其动态变化。结果MCA供血区超急性期脑梗死46例中表现为HMCAS者32例(71.1%),临床均为完全前循环梗死(TACI),25例死亡(78.1%),其中HMCAS进展且合并MCA点状征的14例中12例(85.7%)死亡,其余均遗留严重神经功能缺损;而无HMCAS的14例中8例为部分前循环梗死(PACI),6例为TACI,仅2例(14.3%)死亡,两者差异具有统计学意义(P<0.01)。3例HMCAS在复查随访时消失,病人病情好转且均转化为出血性脑梗死。结论大脑中动脉高密度征的动态CT变化有助于MCA供血区超急性期脑梗死的诊断及预后判断。
Objective To investigate the diagnostic value of HMCAS in the diagnosis of hyperacute infarction in the middle cerebral artery (MCA) donor area. Methods The CT signs and clinical manifestations of 46 cases of hyperacute cerebral infarction (within 6 hours of onset) in the MCA donor area were analyzed and their dynamic changes were observed regularly. Results Of the 46 patients with hyperacute cerebral infarction (MCA), 32 (71.1%) had HMCAS, all had complete anterior circulation infarction (TACI) and 25 died (78.1% Among the 14 cases, 12 (85.7%) died and the rest had serious neurological deficits. Among the 14 cases without HMCAS, 8 cases had partial anterior circulation infarction (PACI), 6 cases had TACI, and only 2 cases (14.3% ) Died, the difference between the two groups was statistically significant (P <0.01). Three cases of HMCAS disappeared in the follow-up visit, the patient’s condition improved and are converted to hemorrhagic cerebral infarction. Conclusion The dynamic CT changes of high density of middle cerebral artery are helpful to the diagnosis and prognosis of hyperacute cerebral infarction in MCA supplying area.