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高场强磁共振弥散 成像诊断短暂性脑 缺血的临床应用价 值探讨*

作者:单 崴

所属单位:河南省商丘市第一人民医院医学影 像中心磁共振室 (河南 商丘 476100)

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摘要

目的 探讨短暂性脑缺血患者采 用高场强磁共振弥散成像诊断的临床效 果。方法 选取本院2013年2月至2015年2 月收治的97例短暂性脑缺血患者为观察 组,其中继发脑梗塞的39例进展型患者为 观察A组,另58例初发型患者为观察B组, 同期选择40例健康成人为对照组,所有样 本均开展高场强磁共振弥散成像检查与颈 动脉彩超检查,并评估磁共振弥散成像与 颈动脉检查结果的相关性,并分析该种诊 断方式在短暂性脑缺血中的应用价值。结 果 观察组患者磁共振检查病灶数、直径 以及颈动脉彩超内膜-中层厚度、斑块发 生率、血栓发生率与中重度狭窄率均高于 对照组;且观察A组患者上述指标除血栓 发生率外均显著高于观察B组,磁共振弥 散成像与颈动脉彩超数据呈正相关性,均 具有统计学意义(P<0.05)。结论 高场强 磁共振弥散成像对短暂性脑缺血的检测结 果同颈动脉彩超呈正相关性,在初发型与 进展型病灶诊断均具良好价值。

Objective To investigate the clinical effects of high-field magnetic resonance diffusion weighted imaging in the transient ischemic diagnosis. Methods 97 cases of transient ischemic patients in our hospital from February 2013 to February 2015 were selected, in which 39 cases of progressive patients secondary infarction were selected as observation group A, and another 58 cases of early onset patients were set as observation group B, and 40 cases of healthy people at the same time were selected as the control group. All these samples were given high-field MR diffusion imaging and carotid ultrasonography, and the relationship between these two results were estimated, the application value of the method in the transient ischemic diagnosis was analyzed. Results The MRI lesion counts, diameter, carotid ultrasound intima-media thickness, each plaque incidence, thrombosis rate, moderate to severe stenosis rate in the observation group were all higher than those in the control group; these indicators except thrombosis rate in the observation group A were significantly higher than those in the observation group B, and MR diffusion imaging and carotid ultrasonography data showed a positive correlation, with statistical significance (P<0.05). Conclusion MR diffusion imaging and carotid ultrasonography data shows a positive correlation, and is valuable in the diagnosis of early onset and progressive lesions.

【关键词】短暂性脑缺血;高场强磁共振 弥散成像;诊断价值

【中图分类号】R445.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.12.008

前言

短暂性脑缺血主要因循环系统微栓子所引发[1],由于脑血管病变 可引发视网膜障碍与脑功能损害等情况,伴随我国国民生活方式日趋 变化,其发病率也呈现逐年升高趋势,导致继发性脑梗塞等病变也愈 加严重[2]。磁共振弥散成像是医学影像技术不断发展的产物,对人体 脑部缺血性病变具有良好敏感性[3];颈动脉彩超可很好发现循环系统 微栓子来源。本研究为进一步明确高场强磁共振弥散成像在短暂性脑 缺血中的诊断价值,针对初发型与进展型患者分别开展了磁共振与颈 动脉彩超检查,旨在通过诊断效果的比较,来为短暂性脑出血检查方 案提供参考建议,现报道如下。