DSA在短暂性脑缺血发作病因诊断中的价值

Values of digital subtraction angiography in etiological among the patients with transient ischemic attack

目的研究DSA对短暂性脑缺血发作（TIA）血管病变的诊断价值,探讨TIA的发病机制.方法选择符合TIA诊断标准的患者66例行DSA检查,观察TIA患者颈内动脉和椎动脉颅内、外血管有无狭窄及粥样硬化斑块.结果 66例患者中发现56例有血管狭窄（84.8%）.其中狭窄程度〉70%23例（34.8%）,50%～70%的25例（37.9%）,〈50%8例（12.1%）,10例正常（15.2%）.颅内段狭窄占36.4%,颅外段狭窄占63.6%.发现狭窄部位有粥样斑块41例,占狭窄动脉的73.2%.频发TIA患者血管狭窄程度多表现为重度（76%）,且多数有粥样硬化斑块.发现4例盗血现象.结论 DSA可以确定TIA患者血管狭窄的程度及溃疡斑块的程度,确定斑块的稳定性与否,对TIA治疗方法的确定有重要作用.

Objective To explore the values of digital subtraction angiography（DSA） in etiological dignosis and the cerebral-vascular pathology base among the patients with transient ischemic attack（TIA）. Methods DSA was performed to investigate the state of inter carotid artery vertebral artery in 66 patients meeting the diagnostic criterion of TIA. ResuIts （1）38 cases（86.4%）were found artery stenosis in 44 cases with internal carotid artery system TIA. 33 cases（75 % ） with internal carotid artery stenosis were greater than 50%, 18 cases （40 %） greater than 70%,Scases（11.2%） less than 30% and 6case（13.6%） normal. Among them 17cases（36.4%）withinteracranial artery stenosis,21 cases（63.6%） with extracranial artery stenosis and 33 cases（86.6%） with plaques in the stenosis were found. （2）18 cases （68.2 %） were found artery stenosis in 22 cases with vertebral artery system TIA. Among them,15 cases（22.7%） with vertebral artery stenosis were greater than 70% ,3 cases（13.6%） less than 50%,and 4 cases（18.2%） normal. Among them,8 cases（44%） with plaque in the stenosis were found. （3） The stenosis degree in 25 frequent TIA patients was great, 19 cases （76 % ） with artery stenosis were greater than 70%,and most were found sclerosis plaque in the stenosis. （4）Stealing phenomena was found in 4 cases. Conclusion DSA can be used to evaluate the extent and characteristic of the lesions,which is important to choose the therapeutic method for the patient with TIA.