HR-MRI血管壁成像在缺血性卒中病因诊断中的应用价值研究

目的 研究高分辨磁共振（high-resolution magnetic resonance imaging，HR-MRI）血管壁成像在缺血性卒中病因诊断中的价值。方法 选择2015年1月-2017年5月于南京鼓楼医院就诊的缺血性卒中患者，头颅数字减影血管造影（digital subtraction angiography，DSA）未能明确病因，而HR-MRI血管壁成像确诊的典型性病例8例进行研究分析。结果 8例缺血性卒中患者，计算机断层扫描血管造影（computed tomography angiography，CTA）/磁共振血管造影（magnetic resonance angiography，MRA）及DSA均未明确病因，HR-MRI血管壁成像发现2例颅内动脉夹层（cerebral artery dissection，CAD），2例烟雾病（Moyamoya disease，MMD），2例动脉粥样硬化烟雾综合征（atherosclerotic Moyamoya syndrome，AS-MMS）及2例原发性中枢神经系统血管炎（primary angiitis of central nervous system，PACNS）。结论 HR-MRI血管壁成像在缺血性卒中病因诊断（如CAD、MMD与AS-MMS的鉴别、PACNS等）中具有重要价值，是CTA/MRA及DSA诊断技术的重要补充。

Study on the Application Value of High-resolution Magnetic Resonance Imaging of Arterial Walls in Etiological Diagnosis of Ischemic Stroke

Objective To study the application value of high-resolution magnetic resonance imaging (HR-MRI) of arterial walls for the etiological diagnosis of ischemic stroke. Methods Eight patients of ischemic stroke with unknown causes using digital subtraction angiography (DSA), which were selected from January 2015 to May 2017 retrospectively in the Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, were etiological diagnosed by HR-MRI, and the results were analyzed. Results All the 8 patients of ischemic stroke were not etiological diagnosed by computed tomography angiography (CTA) / magnetic resonance angiography (MRA) and DSA. Among the 8 patients, 2 cases were identified as cerebral artery dissection (CAD), 2 cases as Moyamoya disease (MMD), 2 cases as atherosclerotic Moyamoya syndrome (AS-MMS) and 2 cases as primary angiitis of the central nervous system (PACNS). Conclusion HR-MRI of arterial walls was of great application value in the etiological diagnosis (for example, CAD, MMD/AS-MMS and PACNS) of ischemic stroke, and was an important complement for the CTA/MRA and DSA.