Cerebral infarction subtypes and brain perfusion abnormalities in 116 patients with middle cerebral artery occlusive disease

Objective To study the cerebral infarction subtypes and brain perfusion abnormalities in patients with middle cerebral artery occlusive disease (MCAOD) based on findings in neuroradiological imaging. Methods In 116 MCAOD cases confirmed by CT angiography (CTA), the data of plain CT scanning, CT perfusion imaging, and CTA were retrospectively analyzed to identify the cerebral infarction subtypes and brain perfusion abnormalities. Results In the 116 cases enrolled in this study, CTA detected 133 middle cerebral arteries (MCA) with stenotie or occlusive lesions, which involved unilateral MCA in 99 cases and bilateral MCA in 17 cases. Severe MCAOD were found in 64 cases (including 25 with MCA occlusion and 39 with severe MCA stenosis), and moderate and mild MCA stenosis in 69 cases. CT or magnetic resonance imaging (MRI) identified multiple lacunar infarctions in 45 cases, territorial infarctions in 26 cases, watershed infarctions of different types in 38 cases, striatocapsular infarctions in 10 cases and no infarction associated with the stenotic MCA in 14 cases. CT perfusion imaging showed hypoperfusion areas in 96 cases (72.2%), including 58 cases with perfusion abnormalities involving large areas in the territory supplied by the MCA; no perfusion abnormalities were found in 37 cases. Conclusion According to the severity and location of MCA stenosis, pathogenesis of stroke and the establishment of collateral circulation, MCAOD may cause different types of cerebral infarction and brain perfusion abnormalities. Key words: Middle cerebral artery occlusive disease;  Cerebral infarction;  CT angiography; CT perfusion imaging