短暂性脑缺血发作磁共振弥散加权成像和临床关系的研究

Study of Relationship between DWI Abnormalities and Clinical Characteristics in Transient Ischemic Attack

目的探讨MRI弥散成像在短暂性脑缺血发作(transient ischemic attack,TIA)患者的临床应用价值。方法对41例TIA患者发病72h内进行常规MRI的T1加权、T2加权、FLAIR和DWI检查,并对DWI阳性和阴性的两组病人进行对比研究。结果 41例患者DWI阳性者17例(占41%),表现与临床相关的局部高信号,其中皮层梗死5例,皮层下梗死12例,DWI阳性与TIA发作持续时间和高级皮层功能显著相关,与肢体的感觉障碍、血脂、TCD异常、心脏疾病、房颤等无相关性。结论 41%TIA的DWI可表现局部高信号提示新近发生的梗死灶,并与持续时间和皮层的高级功能显著相关。

Objective To evaluate the clinical characteristic and diffusion-weighted imagings（DWIs） with TIA.Methods We performed prospectively MRI including DWI in 41 consecutively studied patients with TIA within 72 hours after TIA onset.We compared the clinical background of patients with and without DWI abnormalities.Results 17patients with TIA（41%） had DWI abnormalities（positive group）,whereas 24 patient（59%） had no abnormalities（negative group）.Prolonged TIA duration,dyskinesiaand disturbance of higher brain function are significant and independent factors in correlating with DWI abnormalities.DWI abnormalities.was independent of sensory disorder lipid,abnormality of TCD,cardiac diseases and atrial fibrillation.Conclusion TIA-related DWI abnormalities that suggested recent innfarction are associated with prolonged duration of TIA and disturbance of higher brain function.