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目的分析颈内动脉颅外段(extracranial internal carotid artery,EICA)严重狭窄致脑梗死患者的病灶分布特点。方法对我科住院的40例EICA严重狭窄所致急性脑梗死的患者,在发病后24h内均行颅脑MRI检查、弥散加权成像,所有患者发病后1周内均行颅内非造影剂磁共振血管成像(MRA)、颈部造影剂磁共振血管成像(CE-MRA)。全部做数字减影血管造影(DSA)。结果 40例患者中,穿支动脉供血区梗死13例,占32.5%;分水岭区梗死22例,占50.0%;皮层支动脉供血区梗死3例,占7.5%;大面积梗死2例,占5.0%。左侧颈内动脉(internal ca-rotid artery,ICA)重度狭窄18例,右侧ICA重度狭窄15例,双侧ICA重度狭窄7例。Willis环完整者5例,Willis环不完整者35例。结论 EICA严重狭窄是缺血性脑梗死的重要原因,但受狭窄的程度、斑块性质、侧支循环等影响,颅内梗死灶分布不同。
Objective To analyze the distribution of lesions in patients with cerebral infarction caused by severe stenosis of extracranial internal carotid artery (EICA). Methods Forty patients with acute cerebral infarction caused by severe EICA in our hospital were examined by brain MRI and diffusion weighted imaging within 24 hours after the onset of disease. All patients underwent intracranial non-contrast agent magnetic Resonance angiography (MRA), neck contrast agent magnetic resonance angiography (CE-MRA). All digital subtraction angiography (DSA). Results Of the 40 patients, 13 cases (32.5%) had infarction in perforating branch artery, 22 cases in watershed infarction (50.0%), 3 cases (7.5%) in infarction of cortical branch artery and 2 cases in large infarction %. 18 cases of severe left internal carotid artery (ICA) stenosis, 15 severe stenosis of right ICA and 7 severe stenosis of bilateral ICA. Willis ring complete in 5 cases, Willis ring incomplete in 35 cases. Conclusions Serious stenosis of EICA is an important cause of ischemic cerebral infarction. However, the distribution of intracranial infarcts varies with the degree of stenosis, plaque characteristics and collateral circulation.