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目的评价磁共振弥散成像(DWI)与血管成像(TOF-MRA、3DCE-MRA)对短暂性脑缺血发作(TIA)的应用价值。方法对176例临床证实为TIA患者行MRI(FLAIR)、DWI、TOF-MRA及3DCE-MRA检查。结果176例TIA患者中,48.9%病例DWI显示有超早期小血管梗塞灶,18.2%病例T2WI发现相应病灶。颅动脉检查中,TOF-MRA显示动脉狭窄及闭塞76例(43.2%),其中假阳性与过度评价20例;3DCE-MRA发现颅内动脉狭窄及闭塞69例(39.2%);两者均发现动脉瘤3例及动静脉畸形2例;颈部3DCE-MRA发现动脉狭窄及闭塞38例(21.6%)。结论DWI和MRA检查有助于TIA患者超早期小梗塞灶的发现及动脉病变的评估。
Objective To evaluate the value of magnetic resonance diffusion imaging (DWI) and angiography (TOF-MRA, 3DCE-MRA) in patients with transient ischemic attack (TIA). Methods One hundred and sixty-six patients with clinically proven TIA underwent MRI (FLAIR), DWI, TOF-MRA and 3D CE-MRA. Results In 176 TIA patients, 48.9% of cases showed ultra-early small vessel infarction in DWI and 18.2% of T2WI cases. In the cranial artery examination, TOF-MRA showed 76 cases (43.2%) of the artery stenosis and occlusion, of which 20 cases were false positive and overestimated; 3DCE-MRA found 69 cases (39.2%) of intracranial artery stenosis and occlusion; 3 cases of aneurysms and 2 cases of arteriovenous malformations. 38 cases (21.6%) of them had stenosis and occlusion of arteries detected by 3DCE-MRA in the neck. Conclusions DWI and MRA are helpful for the detection of ultra-early small infarction in TIA patients and assessment of arterial lesions.