颈部血管彩超联合头颅磁共振血管造影在缺血性脑血管病中的诊断价值

Diagnostic value of neck vascular ultrasound combined with magnetic resonance angiography in ischemic cerebrovascular disease

目的探讨颈部血管彩超联合头颅磁共振造影(MRA)对缺血性脑血管病(ICVD)的诊断价值。方法选取脑血栓形成患者92例(A组),短暂性脑缺血发作(TIA)患者37例(B组)及健康体检者50例作为对照组(C组),分别采用颈部血管彩超诊断;92例脑血栓形成患者中80例同时行头颅MRA检查。比较不同人群动脉粥样硬化的发生率及病变特点,比较两种诊断方法对颈内动脉闭塞诊断的吻合程度。结果颈部血管彩超检查结果表明,A、B组间粥样斑块形成、IMT厚度及软斑形成比较差异无统计学意义(P>0.05),与C组比较差异均有统计学意义(P<0.05);3组颈动脉粥样斑块分布比较差异无统计学意义(P>0.05)。颈部血管彩超与头颅MRA对颈内动脉闭塞诊断的吻合率87.50%,对椎动脉闭塞诊断的吻合率75.00%,对轻度狭窄、中度狭窄及重度狭窄诊断的吻合率分别92.86%、94.12%及85.71%。结论颈部血管彩超可为ICVD病变患者颈动脉粥样硬化斑块的形成部位、管腔狭窄程度提供诊断依据,头颅MRA可进一步对颅内血管病变进行诊断,两者联合可更全面评价ICVD病变情况,为临床诊治提供参考。

Objective To investigate the diagnostic value of neck vascular ultrasound combined with magnetic resonance angiography （MRA） in ischemic cerebrovascular disease （ICVD）. Methods 92 cases of cerebral thrombosis patients （group A） ,37 cases of transient ischemic attack （TIA） patients （group B） and 50 cases of healthy persons （group C） were chosen for the study. And the neck vascular ultrasound was used for the diagnosis.Among 92 cases of thrombosis patients ,80 cases were diagnosed by MRA.The atherosclerosis incidence ,lesion characteristics and the extent of the internal carotid artery occlusion diagnosis of all the patients were compared. Results The neck vascular ultrasound showed that there was no statistically sig‐nificant difference of the plaque formation ,IMT thickness and soft plaque formation between the three groups （P〉 0.05） , while compared with group C ,the difference was significant （P0.05）. The diagnosis coincidence rate of the internal carotid artery and verte‐bral artery occlusion were 87.50% and 75.00% ,respectively. The diagnostic coincidence rate of neck vascular ultrasound and MRA for mild stenosis ,moderate stenosis and severe stenosis were 92.86% ,94.12% and 85.71% ,respectively. Conclusion The neck vascular ultrasound can provide diagnostic basis for the carotid artery plaque distribution and stenosis of ICVD pa‐tients ,the MRA can further diagnose the intracranial vascular lesions. The combination of the two methods may be more com‐prehensive evaluated the ICVD disease ,and to provide reference for clinical diagnosis and treatment.