大脑中动脉狭窄的TCD、MRA、DSA检测对比研究

COMPARISON OF TCD,MRA,DSA IN DETECTING MIDDLE CEREBRAL ARTERY STENOSIS

目的以数字减影脑血管造影(DSA)为参照,比较经颅多普勒彩色超声(TCD)、核磁共振血管成像(MRA)、DSA诊断大脑中动脉狭窄的准确性,评价其临床价值。方法对24例经DSA确诊的单双侧43处大脑中动脉狭窄的患者,回顾分析TCD、MRA的检查结果。比较其对大脑中动脉(MCA)M1段、M2段狭窄诊断的准确率。结果 TCD、MRA、DSA诊断MCA M1段、M2段狭窄的准确率分别为82.4%、94.1%、100.0%及22.2%、77.8%、100.0%。三者对MCA M1段狭窄的诊断差异无统计学意义(P>0.05),而对M2段狭窄的诊断,TCD与MRA、DSA比较差异有统计学意义(P<0.05),而MRA与DSA差异无统计学意义(P>0.05)。结论 MRA、DSA均能准确显示MCA狭窄,TCD有局限性,三者均能为临床提供参考价值。

Objective To evaluate the accuracy and clinical diagnostic values Of TCD、MRA、DSA in detecting middle cerebral artery stenosis using DSA as reference.Methods Twenty-four patients with 43 stenosis in unilateral or bilateral MCA diagnosed by DSA were retrospectively analyzed of TCD、MRA imaging findings and compared of the diagnostic accuracy in M1 and M2 stenosis.Results The accuracy of TCD、MRA、DSA in M1 stenosis was 82.4%、94.1%、100% respectively.And that in M2 stenosis was 22.2%,77.8%,100% respectively.There was no difference in diagnosis of M1stenosis（P〉0.05）.There was no difference in diagnosis of M2 stenosis with MRA、DSA（P〉0.05）.But there was obvious difference in M2 stenosis with TCD（P〈0.05）.Conclusion MRA、DSA all have high accuracy of detecting MCA stenosis,but TCD.They play a role in diagnosis of MCA stenosia.