磁共振多扫描技术对短暂性脑缺血病变的诊断价值

Diagnostic value of multi-scan magnetic resonance imaging in transient cerebral ischemia

目的以短暂性脑缺血病变作为观察重点,对磁共振多扫描技术诊断加以分析。方法选取2019年4月至2020年4月湖南省衡阳市中心医院短暂性脑缺血发作(TIA)患者60例,并提供MRI常规序列检查、DWI、MRA、3D-ASL检查,测量颅内患侧脑实质CBF值,对比镜像区域CBF。结果经MRI扫描、DWI,患者未见异常。经MRA扫描,显示血管狭窄患者35例,血管闭塞患者15例,TIA检出率为83.33%,MRA图像阴性患者10例。经ASL扫描,脑灌注减低患者45例,TIA检出率为75.00%。经MRI检查,多灶、单发病灶患者分别为46例、4例,所有多灶患者均为双侧多发,在单发病灶患者中,桥脑2例,小脑半球2例。观察患者病灶位置,半卵圆中心、基底节区、桥脑、丘脑分别为30例,16例,2例,6例。MRA、ASL联合检出率高于单一使用两种检查,对比ASL与对侧CBF,差异有统计学意义(P<0.05)。结论基于TIA患者,通过应用MRA、3D-ASL多扫描技术,可有效提升TIA诊断率,并使该疾病临床治疗工作提供充足依据。

Objective To observe the diagnostic value of multi-scan magnetic resonance imaging(MRI)in transient cerebral ischemia.Methods A total of 60 patients with transient ischemic attack in our hospital from April 2019 to April 2020 were selected as research objects,and all patients were provided with conventional MRI sequence examination,DWI,MRA and 3D-ASL examination.The CBF value of the brain parenchyma on the affected side of the patients was measured,and the CBF in the corresponding mirror area on the opposite side was compared.Results After MRI scan and DWI,no abnormality was detected.After MRA scanning,35 patients had vascular stenosis,15 patients had vascular occlusion,the detection rate of TIA was 83.33%,and 10 patients had negative MRA images.After ASL scan,there were 45 patients with cerebral hypoperfusion,and the detection rate of TIA was 75.00%.After MRI examination,there were 46 patients with multiple lesions and 4 patients with single lesion,and all multifocal patients were bilateral multiple lesions.Among the patients with single lesion,there were 2 cases in pons and 2 cases in cerebellar hemispheres.According to the location of lesions,30 cases,16 cases,2 cases and 6 cases were found in semioval center,basal ganglia,pons and thalamus,respectively.The combined detection rate of MRA and ASL was higher than that of single method,and the difference was statistically significant between ASL and contralateral CBF(P<0.05).Conclusion Based on TIA patients,MRA and 3D-ASL multiscan can effectively improve the diagnostic rate of TIA and provide sufficient evidence for clinical treatment of TIA.