SWI及3D-TOF-MRA对急性心源性脑卒中栓子检测的对比研究

Comparative study of SWI and 3D-TOF-MRA in detection of thrombus in acute cardioembolic stroke

目的探讨SWI、3D-TOF-MRA对于急性心源性脑卒中主要责任血管内栓子检测的临床应用价值。方法50例急性心源性脑卒中患者,分析SWI、3D-TOF-MRA在显示栓子、血管闭塞或狭窄位置匹配度。结果1)本组50例患者,SVS检出率为78%,3D-TOF-MRA检出率为60%,SWI与3D-TOF-MRA的栓子总检出率具有显著差异(P<0.05);9例患者在3D-TOF-MRA为阴性,在SWI可见SVS;2)在SWI与3D-TOF-MRA相一致的30例患者中,M1段栓子在3D-TOF-MRA和SWI检出率均为36%,两者无统计学差异;而对M1段以远栓子的检出率,3D-TOF-MRA为14%,SWI为32%,两者有显著差异(P<0.05)。结论SWI对于ACS患者栓子的准确定位优于3D-TOF-MRA,有望成为判断ACS栓子位置的首选检查,为ACS患者选择治疗方案及评估预后建立新的诊断模式。

Objective To explore the clinical application of SWI and 3D-TOF-MRA in detection of intravascular thrombus in the primary of acute cardioembolic stroke.Methods In 50 patients with acute cardiogenic stroke,SWI and 3D-TOF-MRA were analyzed to determine the matching degree of position in displaying thrombus,vascular occlusion or stenosis.Results 1)In 50 patients,the detection rate of SVS was 78%,3D-TOF-MRA was 60%.There was significant difference in the total detection rate of thrombus between SWI and 3D-TOF-MRA(P<0.05);The SVS was observed in 9 patients without occlusion on 3D-MRA;2)The results of SWI and 3D-TOF-MRA were consistent in 30 patients,the detection rates of thrombus in M1segment were 36%in both examinations,they were no significant difference;while detection rates of thrombus within the distal of M1 segment had significantly difference(32%for SWI versus 14%for 3D-TOF-MRA,P<0.05).Conclusion In this study,we conclude that SWI is superior to 3d-tof-MRA in the accurate positioning of embolus in ACS patients,which is expected to be the first choice to determine the location of ACS emboli and a new diagnostic model for ACS patients to select treatment plan and to evaluate the prognosis will be established.