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目的:本研究旨在识别轴位MRI-T2W流空信号消失,在评估后循环急性缺血性患者椎-基底动脉重度狭窄或闭塞的临床意义。方法:入组急性缺血性卒中住院患者,DWI显示为后循环血管供血区域急性梗死患者,由两名放射科医师判断椎-基底动脉流空信号是否消失。以CTA为金标准,评估轴位MRI-T2W流空信号消失诊断椎-基底动脉重度狭窄或闭塞的准确性。结果:我院神经内科2012年11月至2013年11月期间,符合纳入及排除标准的80例后循环梗死患者中,轴位T2加权MRI显示椎-基底动脉流空信号消失20例、正常60例;轴位T2显示流空信号消失20例中,CTA显示椎-基底动脉重度狭窄或闭塞18例(真阳性率90%)、正常2例(假阳性率10%);T2流空信号正常的60例中,CTA显示,重度狭窄或闭塞2例(假阴性率3.3%),正常58例(真阴性率96.7%)。结论:轴位MRI-T2加权像显示椎-基底动脉流空信号消失,在很大程度上可确定其存在重度狭窄或闭塞,为进行迅速诊断和针对性治疗提供依据。
PURPOSE: This study was designed to identify the loss of axial MRI-T2W flow null signals and to assess the clinical significance of severe stenosis or occlusion of vertebral-basilar artery in patients with acute ischemic circulation. METHODS: In-patients with acute ischemic stroke were enrolled in this study. DWI showed acute infarction in the area of blood supply to the posterior circulation. Two radiologists judged whether the vertebral-basilar artery flow empty signal disappeared. With CTA as the gold standard, the accuracy of the diagnosis of severe stenosis or occlusion of the vertebral-basilar artery was assessed by assessing the disappearance of axial MRI-T2W flow null signals. Results: The neurosurgery department of our hospital from November 2012 to November 2013, 80 eligible patients with posterior circulation infarction, axial T2-weighted MRI showed vertebrobasilar flow empty signal disappeared in 20 cases, normal 60 In the 20 cases of axial flow T2 signal disappearing, CTA showed severe stenosis or occlusion of the vertebrobasilar artery in 18 cases (90% of true positive), 2 cases of normal (false positive rate 10%), normal T2 flow empty signal In 60 cases, CTA showed severe stenosis or occlusion in 2 cases (false negative rate 3.3%) and normal 58 cases (true negative rate 96.7%). CONCLUSION: Axial MRI-T2 weighted imaging shows that the vertebral-basilar artery flow empty signal disappears to a large extent to determine its existence of severe stenosis or occlusion, providing a basis for rapid diagnosis and targeted treatment.