Posterior sirkülasyon infarktında baziler arter dolikoektazisinin MRG ile değerlendirilmesi

Manyetik rezonans görüntüleme (MRG) ve difüzyon ağırlıklı görüntülemede (DAG) akut ve kronik posterior sirkülasyon infarktı saptanan hastaların, baziler arterin dolikoektazisi bakımından değerlendirilmesi amaçlanmıştır. Mart 2008-Mayıs 2009 tarihleri arasında hastanemiz MRG ünitesine iskemik inme ön tanısı ile gelen 495 hasta değerlendirildi. 151 hastada posterior sirkülasyon sahası infarktı tespit edildi. Tanısal olarak yeterli görüntüye sahip 73 hasta çalışmaya dahil edildi. Hastalara 1,5 Tesla MR cihazı ile turbo spin eko (TSE) ve half-fourier acquisition single-shot turbo spin-echo (HASTE) sekansında T2 ağırlıklı görüntüler (AG) ile inceleme ve DAG yapıldı. Çalışmaya dahil edilen hastaların 48’inde (%65,75) akutsubakut, 25’inde (%34,25) kronik süreçte posterior sirkülasyon infarktı tespit edildi. Kontrol grubuna göre hasta grubunun baziler arter çapı değeri istatistiksel anlamlı olarak daha fazla idi (p=0,038). Gruplar arasında baziler arterin şekil dağılımı yönünden istatistiksel olarak anlamlı farklılık görülmedi (p=0,371). Kontrol grubu ve hasta grupları arasında deviasyon derecesi (p=0,682) ve elongasyon derecesi (p=0,220) açısından anlamlı farklılık bulunmadı. Aterosklerotik değişiklikler ile baziler arterin dilatasyonu, posterior sirkülasyon infarktında etkili olabilir. Baziler dolikoektazi kriterlerinden olan dilatasyon, diğer kriterlere göre anlamlı bulunmuştur. Baziler dolikoektazinin patogenezi, klinik önemi ve doğal seyrinin açıklanması için büyük popülasyonlu prospektif çalışmalara ihtiyaç duyulmaktadır. Standart radyolojik baziler dolikoektazi tanısı için, bilimsel olarak kabul gören MRG kriterlerinin geliştirilmesi gerekmektedir.

Evaluation of the dolichoectasia of the basilar artery in patients with posterior circulation infarcts

The purpose of this study was to evaluate the dolichoectasia criteria of basilar arteries in patients with acute and chronic posterior circulation infarcts in magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI). We prospectively evaluated 495 patients with stroke by MRI between March 2008 and May 2009 in Department of Radiology of our hospital. Infarction in posterior circulation was detected in 151 patients. Seventy-three patients with adequate imaging findings were included in this study. Turbo spin echo sequence (TSE), T2 weighted half-fourier acquisition single-shot turbo spin-echo sequence (HASTE), and DWI were performed by 1.5 Tesla MR scanner. Forty-eight of the patients (65,75%) had acute-subacute infarcts, 25 of patients (34,25%) had chronic infarcts with posterior circulation ischemic stroke. Statistical analysis showed that diameter of basilar arteries in patient group were significantly higher than diameter of basilar arteries in control group (p=0,038). Deformation of basilar artery showed no significant differences in all groups (p=0,371). No significant difference was found between control group and patient group for degree of deviation (p=0,682) and elongation (p=0,220) of basilar arteries. Atherosclerotic changes and dilatation of the basilar artery might be effective on posterior circulation infarcts. Basilar dilatation which is a criteria for dolichoectasia has been found to be more significant when compared with other criteria. Prospective large population studies are needed to elucidate the natural history of basilar dolichoectasia and further delineate its clinical significance and underlying pathogenesis. There is need to develop and scientifically validate MRI criteria for the radiological diagnosis of basilar dolicoectasy in order to standardise the diagnosis.

Kaynakça

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  • ISSN: 1300-2317
  • Yayın Aralığı: Yılda 0 Sayı
  • Başlangıç: 2018

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