磁共振扩散加权成像在短暂性脑缺血发作诊断中的应用价值

Application value of diffusion-weighted magnetic resonance imaging in the diagnosis of transient ischemic attack

目的对比短暂性脑缺血发作(TIA)相关责任病灶在弥散加权磁共振成像(DWI)中的检出率,探讨DWI阳性表现与临床症状因素相关性。方法回顾性分析2014年12月至2016年12月韶关市第一人民医院收治的40例TIA患者常规MR和DWI的检查资料,记录各序列的检出率,并就TIA临床特点与DWI阳性的关系进行多元回归分析。结果 DWI对TIA的病灶检出率为40.0%,明显高于FLAIR的17.5%和T2WI的12.5%,差异有统计学意义(P<0.05);脑缺血发作持续时间超过1 h患者15例,占41.7%(15/36),发作时间不足1 h 1例,占25.0%,且发作时间越长,经DWI检测阳性率越高;Logistic多元回归分析结果显示,年龄超过65岁、持续发作时间超过1 h、失语和运动障碍是DWI检出阳性的独立影响因素(P<0.05)。结论 DWI对TIA检出率较高,并且检出率随TIA发作持续时间的延长而增加;年龄超过65岁、持续发作时间超过1 h、失语和运动障碍与DWI检出阳性相关。

Objective To compare the detection rate of diffusion weighted magnetic resonance imaging（DWI）for the responsible lesions of transient ischemic attack（TIA）, and to explore the correlation between DWI positive performance and clinical symptom factors. Methods The clinical data of conventional MR and DWI of 40 patients with TIA admitted to the First People＇s Hospital of Shaoguan from December 2014 to December 2016 were retrospectively analyzed. The detection rate of each sequence was recorded, and the relationship between the clinical features of TIA and DWI positive performance was analyzed by multiple regression. Results The detection rate of DWI for TIA was40.0%, which was significantly higher than 17.5% of FLAIR and 12.5% of T2 WI（P0.05）. The duration of cerebral ischemia lasted more than 1 h in 15 cases, accounting for 41.7%（15/36）, and the time of attack was less than 1 h in 1 case, accounting for 25.0%. The longer the attack time, the higher the positive detection rate of DWI. More than 65 years old, duration of attack for more than 1 hour, aphasia and dyskinesia were independent factors of DWI positive detection.Conclusion DWI has a higher detection rate for TIA, and the detection rate increased with the duration of TIA attack.Over 65 years of age, duration of attack for more than 1 hour, aphasia and dyskinesia were correlated with DWI positive detection.