颅脑磁共振及颈动脉超声成像在TIA患者中的应用价值

Application value of cranial magnetic resonance imaging and carotid artery ultrasound in patients with transient ischemic attack

目的探讨颅脑磁共振及颈动脉超声成像在短暂性脑缺血发作(TIA)患者中的应用价值。方法根据随访过程中是否出现脑梗死将2016年2月至2018年4月间中国人民解放军第95医院诊治的78例TIA患者分为初发型TIA组(66例)和进展型TIA组(12例),所有患者均接受头颅MRI以及双侧颈动脉彩超检测,比较磁共振及颈动脉超声成像对其诊断价值。结果 MRI显示初发型TIA和进展型TIA患者的平均病灶数量[(0.87±0.31)个vs(3.33±0.93)个、病灶平均直径[(10.71±2.42) mm vs (15.74±2.16) mm]及平均体积[(0.88±0.27) cm3vs (1.65±0.41) cm3]比较,初发型TIA患者均明显低于进展型TIA患者,差异均有统计学意义(P<0.05);进展型TIA患者同侧颈动脉内中层厚度为(1.24±0.21) mm,明显大于初发型TIA患者的(1.06±0.30) mm,差异有统计学意义(P<0.05);进展型TIA患者同侧颈动脉存在血栓及狭窄程度≥50%的比例分别为25.00%和33.33%,明显高于初发型TIA患者的4.55%和9.09%,差异均有统计学意义(P<0.05)。结论运用颅脑MRI及颈动脉超声成像不仅可以明确TIA发作病因,而且可以对疾病严重程度以及转归做出评估。

Objective To explore the application value of cranial magnetic resonance imaging and carotid artery ultrasound in patients with transient ischemic attack(TIA). Methods A total of 78 TIA patients, who admitted to the Ninety-fifth Hospital of the Chinese People’s Liberation Army from February 2016 to April 2018, were selected and divided into the primary TIA group(66 cases) and the progressive TIA group(12 cases) according to the occurrence of cerebral infarction in the follow-up process. All patients received head MRI and bilateral carotid artery color Doppler ultrasound examination, and the diagnosis results of the two methods were observed and compared in the tow groups.Results The average number of lesions diagnosed by MRI in the primary TIA group was 0.87±0.31 versus 3.33±0.93 in the progressive TIA group;the average diameter of the lesion was(10.71 ± 2.42) mm versus(15.74 ± 2.16) mm;the mean volume was(0.88±0.27) cm3versus(1.65±0.41) cm3(all P<0.05). The thickness of the ipsilateral carotid artery in the ipsilateral carotid artery of the progressive TIA patients was(1.24±0.21) mm, which was significantly greater than(1.06±0.30) mm of the primary TIA patients(P<0.05). The proportion of thrombus and the degree of stenosis more than50% in the ipsilateral carotid artery of the progressive TIA patients were respectively 25.00% and 33.33%, which were significantly higher than corresponding 4.55% and 9.09% of the primary TIA(P<0.05). Conclusion The use of cranial MRI and carotid ultrasound imaging can not only identify the cause of TIA attack, but also assess the severity and prognosis of the disease.