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目的探讨不典型脑干梗死的临床及磁共振弥散加权成像(DWI)表现。方法分析50例经头颅 DWI 检查证实脑干为责任病灶的急性不典型脑梗死的临床及 DWI 表现。结果 50例脑干梗死患者均不具有脑干病变典型的交叉征表现,只有10例在头颅 CT 脑干处见低密度影,有28例在 T_2WI 及 FLAIR 序列上脑干处显示为高信号,所有病例的 DWI 均显示脑干处高信号或略高信号。结论越来越多的脑干梗死缺乏其典型的临床表现,尤其在反复多发脑梗死病例中,通过 DWI 可明确脑干为责任病灶,在急性不典型脑干梗死显示能力上优于常规序列,对临床治疗及预后判断有十分重要的意义。
Objective To investigate the clinical manifestations of atypical brainstem infarction and diffusion weighted imaging (DWI). Methods Fifty cases of acute atypical cerebral infarction with brain stem as the responsible lesion confirmed by head DWI were analyzed. Results None of the 50 patients with brainstem infarction had a typical crossover sign of brainstem lesion. Only 10 patients showed low density in the cranial CT brain stem and 28 patients showed high signal in the brainstem of T 2 WI and FLAIR sequences. DWI in all cases showed high or slightly higher signal at the brain stem. Conclusion More and more brain stem infarction lacks its typical clinical manifestations. Especially in cases of recurrent multiple cerebral infarction, brain stem can be identified as a responsible lesion by DWI, superior to the conventional sequence in the display ability of acute atypical brainstem infarction, The clinical treatment and prognosis have very important meanings.