短暂性脑缺血发作的脑部磁共振弥散成像与颈动脉彩超联合研究

The study of brain MR DWI and carotid Doppler ultrasound in transient ischemic attacks

目的研究短暂性脑缺血发作的脑部磁共振弥散成像与颈动脉彩超联合研究的方法与临床意义。方法 81例TIA患者在发病两周内行头颅MRI检查及双侧颈动脉彩超检查,其中11例患者在随访时间段内发生继发脑梗塞而再次就诊,为进展型TIA组;其余病例为初发型TIA组。搜集同期健康体检者23例,两组间性别、年龄的差异无统计学意义(均P>0.05)。结果实验组(包括进展型和初发型TIA组)和对照组的DWI阳性率及颈动脉软斑数混合斑数血栓数、IMT依次递减,各指标差异均有显著性统计学意义(P<0.05)。所有研究病例的脑部MRDWI脑梗塞病灶数目和颈动脉总斑块数呈正相关,相关系数分别0.787。结论 MRDWI可发现TIA新发病灶,颈动脉彩超可发现并鉴别颈动脉稳定性和不稳定性斑块及其继发的颈动脉血栓、中内膜增厚、狭窄,对TIA患者的病因诊断及其继发脑梗塞的风险评估均具有重大临床价值,脑部MRDWI脑梗塞病灶数目和颈动脉总斑块数呈正相关。

Objective To study the method and Clinical Value of brain MR DWI and carotid doppler ultrasound in transient ischemic attacks （TIA）. Methods Brain MR DWI and carotid doppler ultrasound were underwent in 81 TIA patients and 23 health checkup people. TIA patients with secondary cerebral infarction were classified study group 1 （n=11）, and the other TIA patients were classified study group 2. The health checkup people were classified normal control group. The differences of sex and age of two groups have no statistical significance. Results The positive rate of MR DWI and carotid doppler ultrasound （including soft plaques, hard plaques, mixed plaques and IMT ） have significant statistical differences （P0.05）. There was positive correlation between the number of brain infarction show by MR DWI and the number of plaques show by carotid doppler ultrasound （r=0.787）. Conclusion MR DWI could show the new brain TIA focus well, carotid doppler ultrasound could distinguish the unstable plaque of carotid and show the the causes of TIA. MR DWI and carotid doppler ultrasound are necessary inspections of TIA patients. The number of brain infarction show by MR DWI were positively correlated with the number of plaques show by carotid doppler ultrasound.