磁共振灌注成像结合脑血管造影评估颈动脉狭窄致短暂性脑缺血发作预后的应用价值

目的研究磁共振灌注成像(perfusion weight imaging,PWI)联合脑血管造影评估颈动脉狭窄致短暂性脑缺血发作(transient ischemic attack,TIA)患者的预后应用价值。方法对80例颈动脉系统TIA患者行PWI检查和全脑数字减影血管造影(digital subtraction angiography,DSA),随访观察90 d脑梗死发生率,分析TIA患者的PWI表现及颈动脉狭窄程度与患者近期预后的相关性。结果 PWI灌注异常的TIA患者90 d发生脑梗死风险明显增加(P0.01);颈动脉狭窄50%TIA者较颈动脉狭窄50%TIA患者90 d发生脑梗死的风险差异有统计学意义(P0.05);PWI灌注异常合并颈动脉狭窄50%组与PWI灌注正常合并颈动脉狭窄50%组患者比较,差异有统计学意义(P0.05)。结论 PWI在评价脑循环的血流动力变化方面有重要的作用,DSA可以对颈动脉狭窄程度做出准确评价。

Prognostic value of combined MR perfusion weight imaging and cerebral vascular angiography in evaluating patients with carotid artery stenosis in transient ischemic attack

Objective To explore the prognostic value of combined MR perfusion weight imaging （PWI） and cerebral vascular angiography in evaluating patients with carotid artery stenosis in transient ischemic attack（TIA）. Methods Eighty patients with carotid artery stenosis in TIA underwent PWI and Digital subtraction angiography （DSA）, their 90d incidence of cerebral infarction was measured, and correlation of PWI performance and the degree of carotid stenosis with the prognosis of patients in the near future was analyzed. Results The risk of cerebral infarction within 90 days was significantly higher in the TIA patients with PWI abnormalities than those with PWI normal （P 〈 0.01 ）, and higher in the patients with 〉 50% carotid artery stenosis than those with 〈 50% carotid artery stenosis （ P 〈 0.05 ）, but no significant difference was detected between patients with PWI abnormalities and 〈 50% carotid artery stenosis and patients with PWI normal and 〈 50% carotid artery stenosis （P 〉 0.05 ） . Conclusion PWI has an important role in the evaluation of hemodynamic changes in the cerebral circulation, while DSA can make an accurate assessment of the degree of carotid stenosis.