彩色多普勒超声与三维增强磁共振血管成像在糖尿病患者椎动脉供血不足病因诊断中的应用

目的探讨彩色多普勒超声(CDFI)与三维增强磁共振血管成像(3D CE MRA)在糖尿病患者椎基底动脉供血不足(VBI)病因诊断中的价值。方法对92例糖尿病并椎动脉供血不足患者行3D CE MRA及CDFI检查,观察椎动脉供血不足的椎动脉病因基础。结果 CDFI检查阳性76例,其中单侧椎动脉受累64例,双侧受累12例,3D CE MRA检查阳性80例,其中单侧椎动脉受累66例,双侧受累14例。两者总的阳性率比较,差异无统计学意义(χ2=0.67,P0.05)。CDFI与3D CE MRA对于椎动脉病变造成的供血不足诊断符合率较高,为95%(76例,80例),在椎动脉狭窄造成椎动脉供血不足诊断中符合率为97%(66例,64例),对椎动脉闭塞造成的供血不足的诊断符合率为100%(4例,4例),对椎动脉发育异常造成供血不足的诊断符合率较低为50%(6例,12例)。结论 3D CE MRA除对局部狭窄所致椎动脉供血不足具有较高准确率外还容易诊断弥漫性长节段狭窄、闭塞及走形异常所致VBI,不足之处费用较高。CDFI和3D CE MRA联合应用能更全面地反映病情,提高VBI诊断阳性率。

The application of color dopplerflow imaging and three dimensional contrast-enhanced magnetic resonance an-giography in the diagnosis of vertebral artery supply insufficiency of diabetes mellitus patients

Objective To assess the clinical values of color doppler flow imaging(CDFI)and three dimention-al contrast enhance magnetic resonance angiography(3D CE MRA)in the diagnosis of vertebral artery supply insuffi-ciency of diabetes mellitus.Methods Ninety-two vertebral arterial supply insufficiency of diabetes mellitus were exam-ined by CDFI and 3D CE MRA to observe the fundamental cause of vertebral artery.Result CDFI was positive in 76 patients with 64 ipsilateral and 12 bilateral.3D CE MRA was positive in 80 patients with 66 ipsilateral and 14 bilateral. There was no significant differences in positive rate of CDFI and 3D CE MRA (χ2 =0.67,P >0.05).The coincidence rate of vertebral arterial lesion was high(95%)in both methods,the coincidence rate of vertebral artery stenosis was 97%,the coincidence rate of vertebral artery occlusion was 100%,and the coincidence rate of ertebral artery with de-velopment alanomaly was low (50%).Conclusion 3D CE MRA is a useful tool in the diagnosis of diffused,long seg-mental artery stenosis and obstruction.The deficiency is high costs.The combination of CDFI and 3D CE MRA can fully reflect the condition and improve diagnostic rate of VBI.