磁共振血管造影在脑血管病诊断中的应用探讨

Application of magnetic resonance angiography in the diagnosis of cerebrovascular disease

目的探讨磁共振血管造影(MRA)在脑血管病诊断中的应用价值。方法对100例脑血管病患者先行MRA检查,并按改良的Seldinger技术进行数字减影血管造影(DSA)检查,血管直径狭窄率大于50%的病变视为严重狭窄。结果DSA结果:41例脑梗死患者中,发现血管闭塞1例,严重血管狭窄者13例,狭窄病变血管16根,Moyamoya病1例,基底动脉梭型动脉瘤1例;45例短暂性脑缺血发作(TIA)患者中,发现血管闭塞2例,严重血管狭窄8例,狭窄病变血管11根;7例蛛网膜下腔出血(SAH)患者中发现动脉瘤4例;3例脑出血患者中发现动静脉畸形1例;2例原发性脑室出血患者中发现Moyamoya病1例;1例癫疒间患者确定为动静脉畸形;1例头痛患者确定为动静脉畸形。MRA结果:41例脑梗死患者中,发现血管闭塞2例,严重血管狭窄17例,狭窄病变血管20根;45例TIA患者中,发现血管闭塞4例,严重血管狭窄9例,狭窄病变血管12根;7例SAH患者中发现动脉瘤2例;余结果与DSA相同。结论MRA对脑血管病诊断有其优越性,有较好的应用前景。

Objective To study the diagnostic value of magnetic resonance angiography （MRA） in patients with cerebrovascular diseases. Methods MRA was performed in 100 cases of cerebrovascular disease, with digital subtraction angiography （DSA, providing the golden standards） also performed by using modified Seldinger technique. Stenotic rate over 50% was taken to mark severe stenosis. Results DSA showed ： In the group of cerebral infarction （ n = 41 ） , there was 1 case of occlusion, 13 severe stenosis （with 16 vessels involved） , 1 Moyamoya disease and 1 fusiform. In the group of transient ischemic attack （ TIA, n = 45 ） , there were 2 cases of occlusion and g cases of severe stenosis （ with 11 vessels involved）. In the group of subarachnoid hemorrhage （ SAH, n = 7）, there were 4 cases of aneurysm. One of the 3 cases of cerebral hemorrhage was related to arteriovenous malformation （AVM）. One of the 2 cases of primary ventricle hemorrhage （PVH） was related to Moyamoya disease. One seizure case and one headache case were found to have AVM. MRA showed： In the 41 cases of cerebral infarction, vascular occlusion was found in 2 cases, sever stenosis was found in 17 cases （ with 22 vessels involved）. In the 45 cases of TIA, occlusion was found in 4 cases ~ 12 vessels with severe stenosis vessels were found in 9 cases. In the 7 cases of SAH, two were found to be related to aneurysm. The other results were alike to that of DSA. Conclusion MRA is still a promising method to diagnose cerebrovascular diseases.