经颅多普勒超声和磁共振血管造影对老年后循环缺血的诊断价值

Comparative study of TCD and MRA for diagnosis of posterior circulation ischemia

目的探讨椎基底动脉经颅多普勒超声(TCD)和磁共振血管造影(MRA)对老年后循环缺血(PCI)的临床诊断价值。方法对临床确诊为老年PCI患者的椎基底动脉系统TCD及MRA的检查资料进行回顾性分析,比较两种检查方法在后循环缺血中的诊断价值。结果共入选我院诊断为PCI的住院老年患者60例,男28例,平均年龄67.4±8.5岁;TCD确诊老年PCI患者56例,TCD的阳性率为93.3%;MRA确诊PCI患者39例,MRA的阳性率为65%。采用配对卡方检验比较不同类型的检出率,χ2=15.21,P<0.05。TCD的阳性检出率高于MRA,且差异有统计学意义。结论 PCI的TCD阳性检出率明显高于MRA,TCD可了解侧支循环的建立情况,但两种检查方法结合起来对老年PCI的病因诊断及临床治疗观察有更大的诊断价值。

Objective To explore the diagnostic value of transcranial Doppler sonagraphy （TCD） and magnetic resonance angiography （MRA） in patients with posterior circulation ischemia （PCI）. Methods We analyzed retrospectively the clinical data of patients who were diagnosed with PCI by TCD and MRA, and compared the two methods of examination in the diagnosis value of PCI. Results A total of 60 elder in-hospital patients （28 men; mean age 67.4 ± 8.5 years） with PCI underwent the diagnostic method assessment. Compared with MAR examination, by which 39 patients were diagnosed as PCI and PCI positive rate was 65%, 56 patients were diagnosed as PCI by TCD and TCD positive rate was 93.3%. The detection rates were compared by matching chi-square test （χ^ 2 =15.21, /9〈0.05）. Positive rate of TCD was higher than that of MRA, and the difference was statistically significant. Conclusions The positive rate of TCD was significantly higher than that of MRA in diagnosis of PCI, and TCD could be used in evaluation of the establishment of collateral circulation situation. Meanwhile, the combination use of TCD and MRA would be helpful to diagnose PCI at early stage.