磁共振血管成像、彩色多普勒超声及经颅多普勒在短暂性脑缺血发作中的诊断价值

Diagnostic Values of Magnetic Resonance Angiography,Color Doppler Ultrasonography and Transcranial Doppler in Transient Ischemic Attacks

目的探讨磁共振血管成像、彩色多普勒超声和经颅多普勒对短暂性脑缺血发作的诊断价值。方法90例短暂性脑缺血发作患者分别行磁共振血管成像、彩色多普勒超声及经颅多普勒检查,并进行分析。结果磁共振血管成像示76例短暂性脑缺血发作患者颅内—外动脉狭窄或闭塞;单纯颅外动脉、单纯颅内动脉、颅内—颅外动脉多发狭窄或闭塞分别为27.8%(25/90)、24.4%(22/90)和32.2%(29/90);颈内动脉系统短暂性脑缺血发作组单纯颅内动脉狭窄或闭塞明显高于椎—基底动脉系统短暂性脑缺血发作组(P<0.01),而椎—基底动脉系统短暂性脑缺血发作组颅内—颅外动脉多发狭窄或闭塞高于颈内动脉系统短暂性脑缺血发作组(P<0.05),两组单纯颅外动脉狭窄或闭塞相近。所有短暂性脑缺血发作患者中,颅外动脉狭窄或闭塞(54.1%)高于颅内动脉狭窄或闭塞(45.9%),颈内动脉系统短暂性脑缺血发作组颅内动脉狭窄或闭塞(53.3%)高于颅外动脉狭窄或闭塞(46.7%),椎—基底动脉系统短暂性脑缺血发作组颅外动脉狭窄或闭塞(64.1%)明显高于颅内动脉狭窄或闭塞(35.9%;P<0.05)。彩色多普勒超声示45例短暂性脑缺血发作患者有颈动脉或椎动脉狭窄或闭塞,73例有颈动脉或椎动脉斑块。72例经颅多普勒异常。结论磁共振血管成像、彩色多普勒超声及经颅多普勒联合应用可对短暂性脑缺血发作的病因作出客观评价,指导治疗。

Aim To investigate the diagnostic values of magnetic resonance angiography （MRA）, color Doppler ultrasonography and Transcranial Doppler （TCD） in patient with Transient ischemic attacks （TIA）. Methods 90 patients with TIA were examined by MRA, color Doppler ultrasonography and TCD. Results MRA showed 76 patients had intracranial or extracranial arteries stenosis or occlusion. 27.8% （25/90）of the cases had either extracranial artery stenosis or occlusion. 24.4% （22/90）of the cases had either intracranial artery stenosis or occlusion. 32.2 % （29/90）of the cases had multiple intra- and extracranial arteries stenosis or occlusion. In ICA-TIA group, there were much more cases had only intracranial artery steno-sis or occlusion than VB-TIA group （P〈0.01）. However, there were fewer cases with multiple inn-a-and extracranial arteries stenosis than VB-TIA group （P〈0.05）. There were almost equal cases with extracranial arteries stenosis in both group. In general, there were more patients with extracranial arteries stenosis or occlusion than intracranial arteries （54.1% vs 45.9%）. In ICA-TIA group, there were slightly more intracranial arteries stenosis than extracranial arteries （53.3 % vs 46.7 %）. However, there were much more extracranial arteries stenosis than intracranial arteries （64.1% vs 35.9%） in VB-TIA group. The difference was significant （P〈0.05）. Carotid or vertebral arteries stenosis or occlusion were detected by color Doppler ultra-sonography in 45 cases and 73 cases were found to have plaques. Carotid arteries stenosis or occlusion were detected by MRA, color Doppler ultrasonography. Abnormalities of intracranial arteries were detected by TCD in 72 cases （80%）. Conclusion MRA, color Doppler ultrasonography and TCD are useful in the evalution of etiological factors and must be examined to guide the treatment for patients with TIA.