弥散加权MRI、DSA、MRA及TCD对短暂脑缺血发作诊断价值的研究

目的评价弥散加权MRI(DWI)、DSA、MRA及TCD对短暂脑缺血发作(TIA)的诊断价值.方法对110例颈内动脉及椎-基底动脉系统TIA患者分别行DWI、MRA、DSA及TCD检查.结果 43%的TIA患者显示小血管腔隙性梗死,其中8%的患者DWI可显示T2WI不能显示的超早期梗死灶;90%的TIA患者DSA显示颈动脉狭窄和(或)相应脑动脉的狭窄及闭塞;48%MRA显示动脉狭窄或不规则.TCD对颈内动脉末端MCA起始部及水平段的中-重度狭窄及闭塞诊断的准确性率为100%.结论 DWI及DSA是诊断TIA患者中超早期脑梗死和显示动脉狭窄及闭塞的敏感手段,可以科学地指导超早期动静脉溶栓治疗,并可作为评价疗效的客观指标;3D-TOF MRA可显示2-3级的脑动脉异常;TCD对中-重度动脉狭窄或闭塞诊断的准确性较高.

Research on the diagnostic values of diffusion weighted imagin,DSA,MRA and TCD in patients with transient ischemic attack

Objective To evaluate the diagnostic value of MR diffusion weighted imaging (DWI),DSA,MRA and TCD in the patients with transient cerebral ischemic attack (TCIA).Methods 110 TCIA patients with cervical carotid arteries and vertebral basil arteries system took DWI,DSA,MRA and TCD tests.Results 43% patients with TCIA showed lacunar infarction and 8% of them could show pre early cerebral infarction by DWI which may not be seen by T 2 WI,90% patients showed carotid arteries stenosis and disease relevant cerebral arteritis,48% patients showed stenosis and irregularity of arteries by MRA.100% moderate to severe stenosis/occlusion of internal carotid artery can be shows by TCD.Conclusions DWI and DSA are highly sensitive in the diagnosis of pre early cerebral infarction and stenosis and occlusion of arteries,they are helpful in guiding the therapy of thrombolysis and in evaluating the therapeutic effect,3D TOF MRA could show the abnormalities of 2 3 grade cerebral vessel,TCD has high accuracy rate in moderate severe arteries stenosis or occulusion.