头颅MRI对急性基底动脉尖综合征的诊断价值分析

Diagnosis Value of Cranial MRI in Acute Top of Basilar Syndrome

目的探讨头颅磁共振成像(MRI)对急性基底动脉尖综合征(TOBS)的诊断价值。方法选取2018年6月至2021年7月商丘市中心医院接收的70例高度疑似急性TOBS患者,均行头颅MRI检查,并以数字减影血管造影(DSA)结果为标准,分析头颅MRI对急性TOBS的诊断价值。结果经DSA诊断结果显示,70例高度疑似急性TOBS患者中确诊39例;经Kappa一致性检验,头颅MRI诊断急性TOBS结果和DSA结果一致性较好(Kappa=0.797,P<0.001);MRI检查显示,39例患者均为多发性脑梗死,病灶数目为2~5个,病灶分布于基底节区10例、丘脑16例、中脑11例、桥脑32例、小脑31例、桥小脑脚2例、枕叶16例、颞叶内侧面11例;MRI扩散加权成像(DWI)序列显示,所有患者责任病灶呈不同程度高信号改变。结论头颅MRI对急性基底动脉尖综合征的诊断价值较高,临床可结合MRI影像学特征及时筛选出急性TOBS患者并制定针对性治疗方案。

Objective To investigate the value of cranial magnetic resonance imaging(MRI) in the evaluation of acute top of basilar syndrome(TOBS).Methods Seventy patients with highly suspected acute TOBS received by Shangqiu Central Hospital from June 2018 to July 2021 were selected,all patients underwent cranial MRI,the value of cranial MRI in the evaluation of acute TOBS was analyzed based on the results of digital subtraction angiography(DSA).Results After DSA diagnosis,the results showed that among 70 patients with highly suspected acute TOBS,39 were diagnosed;by Kappa consistency measure,the results of acute TOBS diagnosed by cranial MRI were consistent with those of DSA(Kappa=0.797,P<0.001);MRI showed that 39 patients had multiple cerebral infarction,with 2-5 lesions,the lesions were distributed in 10 cases of basal ganglia,16 cases of thalamus,11 cases of midbrain,32 cases of pons,31 cases of cerebellum,2 cases of pons cerebellum foot,16 cases of occipital lobe and 11 cases of medial temporal lobe;MRI diffusion weighted imaging(DWI) sequence showed that the responsible lesions of all patients showed high signal changes in varying degrees.Conclusion Cranial MRI is of high value in the evaluation of acute top of basilar syndrome,clinically,patients with acute TOBS can be screened out combined with MRI imaging features,and targeted treatment plans can be formulated in time.