老年短暂性脑缺血发作患者的磁共振弥散加权成像异常与临床特征分析

DWI abnormalities and clinical characteristics in old patients with transient ischemic attack

目的探讨老年短暂性脑缺血发作(TIA)患者的磁共振弥散加权成像(DWI)异常改变与其临床特征的关系。方法63例老年TIA患者分为DWI正常组(38例)和DWI异常组(25例),并对两组患者的临床特征进行比较,应用多因素logistic回归分析获得老年TIA患者DWI异常改变的独立相关因素。结果63例TIA患者中,TIA症状持续时间≥30 min、临床表现为失语和(或)运动障碍以及冠心病及心房颤动病史的患者在DWI多见异常改变,两组差异显著;年龄、性别、TIA发作次数及其他危险因素与DWI异常改变未见相关。结论老年TIA患者的DWI异常改变与TIA症状持续时间及临床表现为失语和(或)运动障碍以及冠心病及心房颤动病史有关。

Objectives To study the relationship between diffusion-weighted imaging（ DWI） abnormalities and clinical characteristics in old patients with transient ischemic attack（TIA）.Methods Sixty-three patients with TIA were examined with MRI. The frequency of TIA-related DWI abnormalities was examined and the clinical characteristics between patients with and without DWI abnormalities were compared. Multivariate statistical method was used to investigate the independent factors associated with detection of DWI abnormalities. Results Twenty-five patients with TIA had DWI abnormalities（ abnormal group）, whereas 38 had no DWI abnormalities （normal group）. Prolonged TIA duration （ TIA duration ≥ 30 min）, aphsia and （or） movement disorders （arm, leg, face）, frequency of attacks, coronary heart disease or atrial fibrillation history, severe carotid ultrasound abnormalities were observed more frequently in the abnormal group than in the normal group. No difference in other TIA risk factors was observed between the two groups. Multivariate logistic regression analysis demonstrated that prolonged TIA duration, aphsia, movement disorders （arm, leg, face）and coronary heart disease or atrial fibrillation were significant independent factors correlating with DWI abnormalities. Conclusions TIA-related DWI abnormalities are associated with prolonged TIA duration, aphasia and （or） movement disorders （ann, leg, face）and coronary heart disease or atrial fibrillation history.