- 期刊
急性腦出血之遠距磁振造影擴散加權影像病灶之相關臨床特性與危險因子
Features of Remote Diffusion Weighted Imaging Lesions in Intracerebral Hemorrhage
摘要
磁振造影檢查發現的遠距磁振造影擴散加權影像病灶（remote DWI lesions［RDWILs］）在急性自發性腦出血病人中並不少見，出現RDWILs常有較差的功能預後及較高的腦中風再發生率與血管性死亡率相關。RDWILs的成因相當多元，其中，腦部小血管病變為RDWILs之一重要危險因子，近期的研究指出，位於不同區域之血塊可反映該患者之腦部血管病變之成因，並可能影響RDWILs出現之位置。研究亦指出混合大葉區與深部區之腦出血（混合性腦出血）可能源自於慢性高血壓相關性血管病變，然而，混合性腦出血是否影響RDWILs之生成目前仍不明，我們探討急性自發性腦出血病人在中風後7日內接受磁振造影檢查，發現混合性腦出血為多發性RDWILs之危險因子。本文回顧近期關於RDWILs之相關文獻，探討RDWILs之臨床特性與危險因子，並簡短介紹我們的研究成果。
並列摘要
Remote diffusion weighted imaging lesions (RDWILs) are acute ischemic lesions frequently seen in patients with acute intracerebral hemorrhage (ICH). They are identified as hyperintense and hypointense lesions on diffusion weighted imaging studies and apparent diffusion coefficient sequences of brain magnetic resonance imaging (MRI) study, respectively. RDWILs are associated with worse functional outcomes and higher risk of recurrent cerebrovascular events and cardiovascular death. The etiologies of RDWILs are heterogenous. Among which, cerebral small vessel disease was found to be a major risk factor of RDWILs. Recent studies reported that different locations of gross hematoma reflecting various underlying cerebral small vessel disease may associate with topographical distribution of RDWILs. Mixed lobar and deep location ICH (mixed-ICH) is related to severe and chronic hypertensive vasculopathy. How mixed-ICH associate with RDWILs is currently unknown. Therefore, in our study, we enrolled ICH patients who received brain MRI study within 7 days after ICH onset and analyzed the associations between RDWILs and mixed-ICH. We found that mixed-ICH correlated with a higher risk of multiple RDWILs. In this article, we will review recent research considering the clinical features and risk factors of RDWILs and briefly summarize our study results.