Взаимосвязь между мозговой перфузией и выраженностью проявлений церебральной болезни мелких сосудов по данным магнитно-резонансной томографии в контексте реабилитационного потенциала острого периода ишемического инсульта
Aim. To study the relationship between cerebral perfusion and severity of cerebral small vessel disease (SVD) in the context of the rehabilitation potential in acute ischemic stroke (IS).
Material and methods. 50 patients with IS and 10 persons of the control group were examined. All patients underwent standard examinations, including brain MRI with an assessment of lacunes, enlarged perivascular spaces (PVS), leukoareosis and cerebral microbleeds (CMB). Cerebral blood flow (CBF) was quantified in the middle cerebral artery territory according to ASPECTS scale by non-contrast magnetic resonance ASL-perfusion.
Results. In patients with IS, unlike the control group, a lower CBF in M3 white matter within both hemispheres and in the cortical part of M6 of the ipsilateral hemisphere is revealed. The number of lacunes in the contralateral hemisphere is related to perfusion in 8 ASPECTS areas. The number of PVS is associated with CBF in insula, lenticular nucleus, M3 of the opposite hemisphere, M6 and internal capsule of the affected hemisphere. The severity of leukoareosis correlates with CBF in 4 zones of the opposite hemisphere. The greatest number of correlations with CBF in basal ganglia was observed for CMBs of the affected hemisphere. Total severity of SVD is also associated with CBF in several areas. The severity of neurological deficiency and dynamics of patient`s mobility, functional and cognitive status correlates with CBF. Conclusion. Global perfusion status is associated with severity of SVD and rehabilitation potential in acute period of IS.