TCD、MRA与DSA在缺血性脑血管病颅内动脉狭窄37例诊断中的对比分析

A comparative detection of TCD and MRA and DSA on cerebral artery stenosis in patients with ischemic cerebrovascular disease

目的:探讨经颅多普勒(TCD)、磁共振血管造影(MRA)、与数字减影血管造影术(DSA)在诊断缺血性脑血管病颅内动脉狭窄的应用。方法:对37例临床高度怀疑颅内动脉狭窄的缺血性脑血管病患者在1周内行TCD与头颅MRA、DSA检查,并与DSA为金标准进行比较。结果:经DSA检查407支脑动脉血管,存在狭窄或闭塞的动脉为106支,阳性率为26.0%;术前行TCD检查,存在狭窄或闭塞的血管中有62支与DSA检查相符,阳性率为15.2%;术前行MRA检查,提示存在狭窄或闭塞的有79支与DSA检查相符,阳性率为19.5%,TCD与DSA检查结果差异有统计学意义(P<0.05),而MRA与DSA检查结果无统计学意义(P>0.05)。结论:MRA、DSA均能准确显示脑动脉狭窄,TCD有局限性,均能为临床提供诊断价值。

Objective：To explore the reliability of trans-craninal Doppler（TCD） and magnetic resonance angiograph（MRA） and digital subtraction angiography（DSA） in the diagnosis of cerebral artery stenosis.Methods：37 patients with ischemic cerebral vascular disease were analyzed and compared with the results of TCD and MRA with DSA.Results： 407 cerebral arteries were examined by the DSA and analyzed the existence of stenosis or occlusion of the artery was 106,the positive rate was 26.0%.With TCD,the existence of stenosis or occlusion of cerebral arteries has 62 checks in line with the DSA,the positive rate was 15.2%.With MRA,the existence of stenosis or occlusion has 79 checked in line with the DSA;the positive rate was 19.5%.The detection result of TCD and DSA has no statistical significance at cerebral artery stenosis（P0.05）.The detection result of MRA and DSA has statistical significance at cerebral artery stenosis（P0.05）.Conclusions： MRA,DSA both have high accuracy of detecting cerebral artery stenosis but TCD.They play a role in diagnosis of cerebral artery stenosis.