DSA在短暂性脑缺血发作病因诊断中的应用

目的探讨全脑数字减影血管造影（DSA）在短暂性脑缺血发作（TIA）病因诊断中的应用价值。方法选择符合TIA诊断标准的82例患者行全脑DSA检查,观察TIA患者颈内动脉和椎—基动脉系统的颅内、颅外段血管情况。结果 82例TIA患者中有血管狭窄或闭塞69例（84.15%）,单纯颅外动脉狭窄或闭塞17例（20.73%）,单纯颅内动脉狭窄或闭塞24例（29.27%）,颅内—外动脉多发性狭窄或闭塞28例（34.15%）。完全闭塞14例（17.7%）,狭窄≥70%者22例（26.83%）、30%～69%者22例（26.83%）、〈30%者11例（13.04%）,正常13例（18.85%）。狭窄部位可见粥样硬化斑块者54例（占狭窄动脉的78.26%）。按受累血管病变部位发生频率依次为颈内动脉起始处、椎动脉V1～3段、大脑中动脉、颈内动脉颅内段、椎动脉V4段、锁骨下动脉、大脑前动脉、颈总动脉、基底动脉、大脑后动脉。结论 DSA对TIA病因诊断有重要作用。TIA患者最常见的原因是脑动脉狭窄及动脉斑块,DSA可以确定TIA患者动脉狭窄程度及斑块程度。

Application of DSA in etiologic diagnosis of transient ischemic attack

Objective To investigate the effect of digital subtraction angiography（DSA） in etiologic diagnosis of transient ischemic attack（TIA）.Methods The situation of carotid artreies and vertebrobasilar,including intracranial and extracranial segments were observed by DSA in 82 TIA patients.Results 69 cases（84.15%） had vascular stenosis or occlusion,17 cases（20.73%） had simple extracranial artery stenosis or occlusion,while 24 cases（29.27%） had simple intracranial arterial stenosis or occlusion,and 28 patients（34.15%）had intracranial and extracranial multiple stenosis or occlusion.In all patients,the one of complete occlusion was 14 cases（17.7%）,≥70% stenosis was 22 cases（26.83%）,30%~69% was 22 cases（26.83%）,30% was 11 cases（13.04%）,and 13 cases（18.85%） was normal.At the site of stenosis,the atherosclerotic plaque was found in 54 cases（78.26%,of all artery stenosis）.According to the frequency of lesion,the locasions respectively were the initial segment of the internal carotid artery,the vertebral artery V1~3 section,the middle cerebral artery,intracranial internal carotid artery,the vertebral artery V4 segment,the subclavian artery,anterior cerebral artery,carotid artery,basilar artery,and posterior cerebral artery.Conclusions DSA play an important role in the etiological diagnosis of TIA.The most common cause of patients with TIA is artery stenosis and atherosclerotic plaques.With DSA,the degree of arterial stenosis and plaque in TIA patients are determined.