Correlation between cerebral blood flow and cerebral infarction in patients with chronic middle cerebral artery occlusion detected by ultrasound
10.3969/j.issn.1672-5921.2017.05.005
- VernacularTitle:超声检测大脑中动脉慢性闭塞患者脑血流与脑梗死的相关性
- Author:
Xiang LI
;
Xuehua HAN
;
Yang HUA
;
Jie YANG
;
Chengzi JIN
- Keywords:
Middle cerebral artery occlusion;
Transcranial Doppler;
Transcranial color-coded sonography;
Diffusion-weighted imaging
- From:
Chinese Journal of Cerebrovascular Diseases
2017;14(5):245-249
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To investigate the effect of leptomeningeal anastomoses (LMA) compensation of anterior cerebral artery (ACA) on the size of cerebral infarction in patients with chronic middle cerebral artery occlusion (CMCAO) and to analyze the correlation between middle cerebral artery (MCA) velocity and cerebral infarction area.Methods From June 2014 to June 2016,35 consecutive patients with CMCAO from the Department of Neurology,Yanbian University Hospital and 74 with CMCAO from the Department of Neurology,Beijing Xuanwu Hospital,Capital Medical University were enrolled retrospectively.All patients were diagnosed as CMCAO on one side and MCA was normal on the other side with transcranial Doppler (TCD) or transcranial color-coded sonography (TCCS) and confirmed by digital subtraction angiography (DSA).They were divided into either a LMA group (n=49) or a non-LMA (NLMA) group (n=60) according to the DSA revealed ACA.TCCS and/or TCD were used to measure and record the peak systolic velocity (PSV) and mean flow velocity (MFV) of the contralateral and ipsilateral MCA,and the ratios of bilateral PSV were calculated.They were divided into 4 grades,including normal brain tissue,cerebral lacunar infarction,small and moderate cerebral infarction,and large cerebral infarction according to the findings of diffusion-weighted imaging (DWI).Mann-Whitney test was used to compare the differences of cerebral infarction areas between the LMA group and the NLMA group,and Spearman rank correlation analysis was used to analyze the correlation between the MCA blood flow parameters of the ipsilateral side and the cerebral infarction area.Results (1) The patients with stroke accounted for 90.0% (n=54) in the NLMA group,and it was significantly higher than 71.4% (n=35) in the LAM group.There was significant difference between the two groups (P<0.05).(2) The severity of cerebral infarction in the NLMA group was significantly higher than that in the LMA group.DWI revealed that the LMA group was mainly lacunar infarction (51.0%,n=25),the NLMA group was mainly small and moderate infarction (45.0%,n=27),the incidence of large infarction (21.7%,n=13) was higher than that in the LMA group (4.1%,n=2).The difference between the two groups was statistically significant (P<0.01).(3) The cerebral infarction area in patients of the NLMA group showed moderately negative correlation with PSV of MCA (r=-0.736,P<0.01),and increased with the increase of contralateral side of PSV/ipsilateral side of PSV,there was a high positive correlation (r=0.849,P<0.01).Conclusion The compensatory function of meningeal branches of the anterior cerebral artery in patients with CMCAO was associated with the severity of cerebral infarction.The decreased MCA blood flow velocity on the ipsilateral side had a significant correlation with cerebral infarction area.
