短暂性脑缺血发作的磁共振弥散加权成像表现与临床因素的关系

Correlation between the abnormalities in diffusion-weighted MRI and the clinical factors in patients with transient ischemis of brain

目的评价磁共振弥散加权成像(DWI)对短暂性脑缺血发作(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3～7月在发病后7天内进行常规MRI和DWI检查的59例TIA患者的临床资料。对TIA患者DWI表现和临床因素的关系进行分析。结果59例TIA患者中,22例(37%)有DWI异常(阳性组),37例(63%)无DWI异常(阴性组)。有DWI异常者更多见于TIA持续时间较长(≥30min)、发作频繁、有运动障碍、失语、脑卒中或TIA史、糖尿病和房颤患者。22例DWI异常者中9例在常规MRI上未显示病灶,13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、有运动障碍、失语、脑卒中或TIA史、糖尿病和房颤史与DWI异常显著相关。

Objective To evaluate the utility of diffusion--weighted MRI（DWI） and the correlation between the abnormalities in DWI and the clinical factors in patiems with transient ischemic attack of the brain （TIA）. Method Clinical, convemional MRI, and DWI data were collected on 59 consecutive patients with TIA between March and July 2006 within 7 days of the onset of TIA symptoms. The relationship between DWI-detected findings and patients＇ clinical manifestations was then analyzed, Results DWI-detected abnormalities were displayed in 22 of 59 cases （37%, positive group）. Prolonged TIA duration （TIA duration≥30 minutes）, repeated 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 9 of 22 cases, the identified lesions were not detected by conventional MRI （T2-weighted imaging or fluidattenuated inversion recovery [FLAIR]）. In other 13 cases, abnormalities were present on both DWI and conventional MRI. Conclusions In TIA patients, prolonged TIA duration （TIA duration≥30 minutes）, repeated episodes, motor deficits, aphasia, history of either stroke or TIA, diabetes mellitus, and atrial fibrillation were significantly correlated with detectable abnormalities on DWI.