摘要： 研究背景 通过对不同磁共振成像和脑血管造影资料分析，了解脑桥梗死与后循环血管病变之间的关系，并对不同类型单纯脑桥梗死病因进行分型，比较不同分型方法间的临床特征。方法 选择首次发病的单纯急性脑桥梗死患者进行病因分析，根据影像学检查分为大动脉闭塞性疾病型、基底动脉分支病变型、小动脉型、其他原因型和病因不确定型；同时参照TOAST分型，分为大动脉粥样硬化型、小动脉闭塞型、心源性栓塞型、其他明确病因型和不明原因型。结果 在影像学分型中以基底动脉分支病变型脑桥梗死常见，约占50.59%（43/85），然后依次为小动脉闭塞型28.23%（24/85）、大动脉闭塞性疾病型14.12%（12/85）、病因不确定型7.06%（6/85 ）；TOAST分型中以小动脉闭塞型为主，占67.06%（57/85），其次为大动脉粥样硬化型30.59%（26/85）、不明原因型 2.35%（2/85 ），未发现心源性栓塞型和其他明确病因型。结论 单纯脑桥梗死在TOAST分型中以小动脉闭塞型为常见病因，基于多种脑血管造影检查方法对其进行TOAST分型，对制定具有针对性的治疗方案至关重要。

关键词:  急性病, 脑梗死, 脑桥

Abstract: Background  Through the analysis of various imaging and angiography data, including computed tomography angiography (CTA), magnetic resonance angiography (MRA) and digital subtraction angiography (DSA), this article aims to understand the relation between pontine infarction and posterior circulation lesions, classify different types of causes of isolated pontine infarction, and compare the clinical characteristics of different classification methods. Methods Eighty-five cases with first-onset isolated pontine infarction were selected. On the basis of imaging examinations, they were divided into the following categories: vertebrobasilar large-artery disease (VLAD); basal artery branch disease (BABD); small artery disease (SAD); type of other reasons and type of uncertain causes. According to Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification standard, all patients were divided into the following categories: large artery atherosclerosis (LAA), small artery occlusion (SAO), cardiac embolism (CE), stroke of other determined etiology (SOE), stroke of undetermined etiology (SUE). Results  According to imaging classification, BABD was the most common type, accounting for 50.59% (43/85); SAD accounted for 28.23% (24/85); VLAD accounted for 14.12% (12/85); type of uncertain causes accounted for 7.06% (6/85); type of other reasons was not found. Based on the TOAST classification, SAO was the most common type, accounting for 67.06% (57/85); LAA accounted for 30.59% (26/85); SUE accounted for 2.35%(2/85); CE and SOE were not found. Conclusion  Based on the TOAST classification, small artery occlusion is the most common etiology of isolated pontine infarction. It is favorable for formulating specific treatment to make TOAST classification based on a variety of imaging data.

Key words: Acute disease, Brain infarction, Pons