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目的评价磁共振弥散加权成像(DWI)在鉴别栓塞性脑梗死中的诊断价值。方法对202例急性颈内动脉及椎基底动脉系统脑梗死患者分别进行MRI(T1、T2、FLAIR、DWI)、磁共振血管造影(MRA)、颈动脉超声、经颅多普勒超声(TCD)及超声心动图(UCG)等检查,比较栓塞源性卒中的特点。结果有心源性栓塞病因的脑梗死患者30(14.9%),DWI证例实单发梗死12(5.9%),多例发梗死18(8.9%);无例明确栓塞病因的脑梗死患者,经DWI证实有71(35.1%)例患者存在多发的、时间上关系密切的急性栓塞性梗死灶;全部栓塞性脑梗死患者中,小血管腔隙性梗死的患者有46例(22.8%)。结论DWI能区分急、慢性脑缺血,协助鉴别责任病灶,有助于进一步筛查卒中的病因及二级预防的开展;MRA、颈动脉超声、TCD及超声心动图等检查在卒中病因学调查中起重要作用。
Objective To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) in the differential diagnosis of embolic cerebral infarction. Methods Totally 202 patients with acute internal carotid artery and vertebrobasilar cerebral infarction underwent MRI (T1, T2, FLAIR, DWI), magnetic resonance angiography (MRA), carotid artery ultrasound, transcranial Doppler ultrasound (TCD) And echocardiography (UCG) and other tests to compare the characteristics of embolic stroke. RESULTS: Thirty (14.9%) patients with etiological embolic etiology were found to have infarction, 12 (5.9%) single infarction and 18 (8.9%) multiple eases with DWI. DWI confirmed the presence of multiple, time-sensitive acute embolic infarcts in 71 (35.1%) of the patients and in 46 of 46 (22.8%) patients with small blood vessel lacunar infarcts in all embolic infarctions. Conclusion DWI can differentiate acute and chronic cerebral ischemia and help identify the responsible lesion, which is helpful to further screening the etiology and secondary prevention of stroke. MRA, carotid artery ultrasonography, TCD and echocardiography were used in the investigation of stroke etiology Play an important role.