造影增强MR血管成像对急性缺血性中风患者血管状况的评估价值

目的:探讨CE-MRA在急性缺血性中风患者血管状况评估中的可行性。方法:27例大脑中动脉供血区急性缺血性中风患者在发病后6h内进行了TOF-MRA和CE-MRA检查,根据随访结果,对TOF-MRA和CE-MRA在急性缺血性中风患者血管状况的评估价值进行了对比分析。结果:①在27例患者中,有11例患者在TOF-MRA上表现为大脑中动脉完全闭塞而在CE-MRA上仍可见残余血流,随访结果与CE-MRA结果一致;②CE-MRA的扫描时间明显短于TOF-MRA;③CE-MRA可以在不增加扫描时间的情况下对颈部动脉和颅内动脉同时成像。结论:CE-MRA能够及时、准确地对急性缺血性中风患者血管状况进行评估,优于常规的TOF-MRA,由于急性缺血性中风患者需要紧急处理,在应用MR评估血管状况时CE-MRA应为首选。

Evaluation of the vascular patency in patients with acute ischemic stroke via CE-MR angiography

Objective:To investigate the feasibility of contrast-enhanced MR angiography(CE-MRA) technique in the evaluation of the vascular patency in patients with acute ischemic stroke.Methods:Twenty-seven patients with symptoms of acute ischemic stroke due to middle cerebral artery occlusions underwent TOF-MRA and CE-MRA within 6 hours after the onset of symptoms.The value of TOF-MRA and CE-MRA in the evaluation of vascular patency was compared according to the findings from follow-up MR imaging.The scan time of CE-MRA was obviously shorter than that of TOF-MRA.Both TOF-MRA and CE-MRA could display the arterial occlusion or stenosis in the 27 patients.There were more artifacts in TOF-MRA than that in CE-MRA.In 11 patients,the TOF-MRA overestimated the stenosis and appeared as complete arterial occlusion,but the CE-MRA displayed the remaining blood flow,which was confirmed by follow-up MR imaging.In addition,CE-MRA could display carotid and intracranianl arteries simultaneously.Conclusion:CE-MRA can more rapidly and accurately evaluate the vascular patency than TOF-MRA in patients with acute ischemic stroke.In view of the emergent settings of acute ischemic stroke,CE-MRA is of choice to be used to evaluate the vascular patency.