급성 다발성 뇌경색 환자에서 확산강조자기공명상의 유용성

Abstract

While we often observe acute multiple brain infarction (AMBI), their clinical significance has not been fully investigated. We sought to determine the relationship between the characteristics of AMBI in diffusion-weighted imaging (DWI) and internal carotid artery (ICA) disease and middle cerebral artery (MCA) disease of unilateral AMBI in the anterior circulation. We studied 107 consecutive ischemic stoke patients who underwent DWI and MRI/MR angiography within 3 days of stroke onset. Patients were assigned to 1 of 5 observed lesion characteristics in DWI: (1) multiple small lesions (<1 cm), (2) multiple small and medium lesions (1 to 3cm), (3) multiple small and large lesions (>3 cm), (4) multiple lesions in hemodynamic risk zone, and (5) others. The involvement of insula, periventricular white matter (PVWM), basal ganglia, and cortex was also investigated. Comparisons of all these characteristics were made between ICA disease patients (ICA group, n=43) and MCA disease patients (MCA group, n=64) on MR angiography. There was no significant relationship between cerebral artery involvement and the characteristics of lesions in DWI. Between 2 groups of arterial disease, maximum diameter of lesion which is more than 3 cm and PVWM involvement were significantly related with MCA group (p=0.02 and p=0.007). The pathogenic mechanisms of unilateral AMBI can be predicted by the characteristic of its size and location using DWI.