MRA对脑梗死患者颅内动脉狭窄、闭塞的诊断价值

The Role of MRA in Diagnosis of Intracranial Artery Steno-occlusive Disease in Patients with Cerebral Infarction

目的探讨3D-TOF MRA在脑梗死患者中对颅内动脉狭窄、闭塞的诊断价值.方法回顾性总结分析66例临床确诊的脑梗死患者的常规MRI扫描表现,3D-TOF MRA序列上颈内动脉颅内段、椎动脉颅内段、基底动脉、大脑前动脉、大脑中动脉及大脑后动脉主干及一级分支的表现,并观察颅内动脉的狭窄和闭塞与梗死灶的关系.结果急性梗死43例,亚急性梗死14例,慢性梗死9例.颈内动脉系统梗死55例、椎-基底动脉系统梗死11例;动脉病变25例(37.8%),其中大动脉狭窄17例25处,闭塞3例3处;小动脉狭窄5例11处.结论脑梗死患者中常规进行颅脑3D-TOF MRA检查,对狭窄和闭塞动脉的检出有良好的效果,有助于制定治疗计划和判定预后.

Objective To study the value of 3D time-of-flight magnetic resonance angiography （3D-TOF MRA） in diagnosis of intracranial artery steno-occlusive disease in patients with the cerebral infarction. Methods In 66 patients with cerebral infarction, the findings of the common MR scanning of the brain and imagings of the intracranial arteries by 3D-TOF MRA were analyzed retrospectively. The intracranial artery seg- ments evaluated were internal carotid artery, vertebral artery, basilar artery, A1 of anterior cerebral artery, M1 of middle cerebral artery, P1 of posterior cerebral artery, and their first branches. The attention was paid for the relationship between the intracranial artery steno-occlusive findings and cerebral infarcts. Results There were 43 cases of the acute cerebral infarction, 14 cases of the subacute and 9 cases of the chronic. In other words, there were 55 cases of internal carotid artery system infarction and 11 cases of vertebral-basilar artery system in- farction. In total, 25 （37.8 %） cases of intraeranial artery steno-occlusive disease were found, including 17cases （or 25 segments ） of stenosis and 3 cases （or 3 segments） of occlusion in the bigger artery, and 5 cases （or 11 segments ） of stenosis in the small artery. Conclusion 33D-TOF MRA is an effective conventional means in diagnosis of intracranial artery steno-occlusive disease in patients with cerebral infarction. That is helpful in making the treatment plans and evaluating prognosis of the patients.