短暂性脑缺血发作的DWI表现和临床因素的关系

目的:评价磁共振弥散加权成像(diffusion-weighted MRI,DWI)对短暂性脑缺血发作(transient ischemic attack,TIA)患者的应用价值,以及DWI异常与临床因素的关系。方法:研究2006年3～9月间在发病后7天内进行常规MRI和DWI检查的81例TIA患者。对TIA患者DWI表现和临床因素的关系进行分析。结果:32例TIA患者有DWI异常(32／81,39％),49例无DWI异常(49／81,61％)。DWI异常者更多见于TIA持续时间较长(≥30分钟),发作频繁,有运动障碍,失语,脑卒中或TIA史,糖尿病和房颤者。32例有DWI异常者中13例在常规MRI上未显示病灶, 19例在常规MRI(T2和FLAIR)上也显示异常。结论:在临床诊断的TIA患者中,症状持续时间较长,发作频繁,运动障碍,失语,脑卒中或TIA史,糖尿病和房颤者是与DWI异常显著相关的因素。

The Correlation Between Diffusion-Weighted MRI Abnormalities and Clinical factors in Patients With Transient lschemic Attack

Objective: To evaluate the utility of diffusion-weighted MRKDWI) and determine the correlation between DWI abnormalities and clinical factors in patients with transient ischemic attack (TIA). Method: Clinical, conventional MRI, and DWI data were collected on 81 consecutive patients with TIA between March and September 2006 within 7 days of symptom onset. The relationship between DWI-detected findings and patients' clinical presentation was then analyzed. Results; DWI-detected abnormalities were present in 32 of 81 cases (39% ,positive group). Prolonged TIA duration (TIA duration≥30 minutes), multiple episodes, motor deficits, aphasia, history of either stroke or TIA, diabetes mellitus, and atrial fibrillation were observed more frequently in the positive group than in the negative group. In 13 of 32 cases, the identified lesions not detected by conventional MRI (T2-weighted imaging or fluid-attenuated inversion recovery [FLAIR]). In 19 of 32 cases, a DWI abnormality was present on both DWI and conventional MRI. Conclusions: In TIA patients, Prolonged TIA duration (TIA duration≥30 minutes), multiple episodes, motor deficits, aphasia, history of either stroke or TIA, diabetes mellitus, and atrial fibrillation were correlated with detecting an abnormality with DWI.