不同影像学检查对儿童动脉缺血性脑卒中的诊断价值  

Diagnostic Values of Different Kinds of Imageology Examination on Artery Ischemic Stroke in Children

作　　者：李久伟[1] 蒋丽琼[1] 王建军[1] 石凯丽[1] 邹丽萍[1] 

机构地区：[1]首都医科大学附属北京儿童医院神经内科,北京100045

出　　处：《实用儿科临床杂志》2008年第12期900-902,共3页Journal of Applied Clinical Pediatrics

基　　金：首都医学发展科研基金项目资助(2005-1012)

摘　　要：目的探讨头颅CT、MRI及磁共振血管造影术(MRA)对儿童动脉缺血性脑卒中(AIS)的诊断价值。方法选取AIS患儿157例。男92例,女65例;年龄4个月～16岁。病程3h～21d。患儿均有肢体瘫痪或面瘫。回顾性分析157例AIS患儿的病历资料,对其头颅CT、MRI、MRA、MRI加MRA结果进行比较,分别计算头颅CT、MRI、MRA、MRI加MRA的受检总人数和AIS阳性检出率;CT和MRI对不同梗死部位显示的例数和阳性率,MRA对不同大血管病变显示的例数和阳性率。采用SPSS11.5软件进行统计学分析。结果头颅CT、MRI、MRA、MRI加MRA的AIS阳性检出率分别为84.3%、93.5%、70.7%和97.3%。CT与MRI及MRA比较均有显著性差异(Pa<0.05);MRI与MRA、CT与MRI加MRA,MRA与MRI加MRA比较均有非常显著性差异(Pa<0.01);MRI与MRI加MRA比较无显著性差异(P>0.05)。53.2%患儿的MRI显示多部位梗死灶,CT仅为20.6%,二者比较差异具有非常显著性差异(P<0.01)。116例接受MRA检查,82例(70.7%)示脑血管狭窄或闭塞性改变,余34例行MRI及其他检查证实有血管闭塞。结论MRI阳性检出率较CT高,在多部位梗死灶显示方面更具有优势。MRA阳性检出率较CT低。同时行MRA与MRI检查较单独行MRA的阳性检出率高,但并不比单独行MRI的阳性检出率高。Objective To explore the diagnostic values of computerized tomography （ CT）, magnetic resonance imaging （MRI） and magnetic resonance angiography （MRA） on artery ischemic stroke （AIS） in children. Methods One hundred and fifty-seven children （ 92 males, 65 females, aged from 4 months to 16 years old） with AIS were analyzed retrospectively in the study. All the patients suffered from paralysis and their courses of disease before hospitaliZation ranged from 3 hours to 21 days. The findings of head CT , MRI, MRA, MRI combined MRA scans were compared among each other. Positive detection rates of CT, MRI, MRA, MRI combined MRA scans and the number of patients who received the scans were calculated respectively. Number and positive detection rates of CT and MRI in displaying different infarction focuses and those of MRA in displaying infarctions of great vessels were caculated respectively, too. The resuhs were analyzed with SPSS 11.5 software. Results The positive detection rates of CT, MRI, MRA, MRI combined MRA were 84.3 % ,93.5 % ,70.7 % and 97.3 % respectively. There were significant differences in the positive detection rates between CT and MRI, CT and MRA（ Pa〈 0.05 ）. There were very significant differences in positive rates between MRI and MRA, CT and MRI combined MRA, MRA and MRI combined MRA（ Pa 〈 0.01 ）. NO significant difference existed of positive detection rates between MRI and MRI combined MRA （ P 〉 0.05 ）. And 53.2% of the patients showed muhiple infarction focuses in MRI, and only 20.6% in CT, the difference was very significant （P 〈 0.01 ）. Among of 157 cases, 116 cases were examined with MRA,82 cases （70.7%）showed carebral vessels angiostegnosis or obstruction, and 34 cases were confirmed vascular occlusion by MRI or others. Conclusions The positive detection rate of MRI is highest and MRA is lowest. MRI is more powerful than CT in terms of the capacity of displaying muhiple infarction focuses. The positive detecion rate can not be improved when both MRI

关 键 词：计算机断层扫描 磁共振成像 磁共振血管造影术 动脉缺血性脑卒中 儿童 

分 类 号：R743[医药卫生—神经病学与精神病学]