高分辨磁共振在青年卒中颅内动脉狭窄病因诊断的研究

目的回顾性分析青年卒中患者颅内动脉狭窄的临床及影像学资料,探讨高分辨MRI(HR-MRI)血管壁成像对青年卒中患者颅内动脉狭窄病因的诊断。方法收集2016年1月至2019年9月就诊于盐城市第三人民医院的缺血性青年卒中患者的临床资料,分为病程14 d内进行HR-MRI扫描的80例患者(实验组),以及同期内行CTA检查,而未行HR-MRI或DSA检查的189例患者(对照组)。对两组数据进行相关分析。结果实验组中诊断为动脉粥样硬化性狭窄52例(65.00%),动脉夹层12例(15.00%),血管炎性病变7例(8.75%),烟雾病8例(10.00%),病因不明1例(1.25%)。对照组中诊断为动脉粥样硬化性狭窄146例(77.20%),动脉夹层10例(5.30%),血管炎性病变4例(2.10%),烟雾病25例(13.20%),病因不明4例(2.10%),实验组中动脉粥样硬化性狭窄诊断率低于对照组,差异有统计学意义(P<0.05);动脉夹层、血管炎性病变诊断率高于对照组,差异有统计学意义(均P<0.05);烟雾病、病因不明的诊断率虽然低于对照组,但无统计学意义。结论 HR-MRI血管壁成像在青年卒中颅内动脉狭窄病因诊断中具有重要价值,能提高病因诊断的准确率。

High resolution magnetic resonance imaging in the diagnosis of intracranial artery stenosis in young stroke patients

Objective To retrospectively analyze the clinical and imaging data of intracranial artery stenosis in young stroke patients,and to explore the diagnosis of intracranial artery stenosis in young stroke patients with high resolution MRI(HR-MRI).Methods Retrospective analysis was performed on 80 patients with ischemic stroke who were admitted to the Third People's Hospital of yancheng from January 2016 to September 2019 and underwent HR-MRI scanning within 14 d(the experimental group).Meanwhile,the data of 189 young patients with ischemic stroke who underwent CTA examination but did not receive HR-MRI or DSA examination during the same period were analyzed(the control group),and data of the two groups were statistically analyzed.Results In the experimental group,there were 52 cases(65.00%)of atherosclerotic stenosis,12 cases(15.00%)of arterial dissection,7 cases(8.75%)of vascular inflammatory lesions,8 cases(10.00%)of moyamoya disease,and 1 case(1.25%)of unknown etiology.In the control group,146 cases(77.20%)were diagnosed as atherosclerotic stenosis,10 cases(5.30%)were diagnosed as arterial dissection,4 cases(2.10%)were diagnosed as vascular inflammatory lesions,and 25 cases(13.20%)were diagnosed as moyamoya disease and 4 cases(2.1%)were diagnosed as unknown etiology.The diagnosis rate of atherosclerotic stenosis in the experimental group was significantly lower than that in the control group with statistical significance(P<0.05).The diagnosis rate of arterial dissection and inflammatory lesions was significantly higher than that of the control group with statistical significance(all P<0.05).Although the diagnosis rate of moyamoya disease and unknown etiology was lower than the control group,it was not statistically significant.Conclusion HR-MRI vascular wall imaging has important value in the etiological diagnosis of intracranial artery stenosis in young stroke,and can improve the accuracy of etiological diagnosis.