DWI检查结合脑TCD、颈动脉超声在判定急性脑梗死诊断分型中的价值  

Clinical Application Value of Diffusion-weighted MRI, TCD and CAU after Acute Ischemic Stroke

作　　者：周铁柱[1] 车玉琴[1] 

机构地区：[1]中国医科大学附属第四医院神经内科,辽宁沈阳110032

出　　处：《中国血液流变学杂志》2010年第2期212-215,共4页Chinese Journal of Hemorheology

基　　金：辽宁省科学技术计划项目 （2008225026）

摘　　要：目的 急性脑梗死患者进行MRI弥散加权成像（Diffusion Weighted Imaging,DWI）结合脑TCD（Transcranial Doppler Ultrasound,TCD）、颈动脉超声（Carotid Artery Ultrasonography, CAU）推断动脉病变与数字减影血管造影（Digital Subtraction Angiography,DSA） 比较,以明确其在中国缺血性卒中亚型（China Ischemic Stroke Subtype,CISS）分型中的价值.方法 对183例疑诊急性脑梗死的患者在发病后1h～3d内行颅脑CT、常规MRI和DWI进行影像学分析,DWI上显示高信号后,采用脑TCD检查颅内脑动脉血流速度、频谱分析,颈动脉超声检查颅外动脉粥样硬化斑块、有无狭窄或闭塞;最终经DSA明确颅内外动脉狭窄、侧枝循环评价;将DWI与脑TCD、CAU联合检查（DWI＋TCD＋CAU）与DSA检查结果比较,分析 DWI＋TCD＋CAU敏感性与特异性.结果 DWI＋脑TCD＋颈动脉超声与DSA对比,诊断敏感性90.7%,特异性90.9 %.结论 DWI结合脑TCD、颈动脉超声,在急性脑梗死CISS分型中具有重要的价值.Objective The patients with acute cerebral infarction were examined by diffusion weighted imaging, combined with cerebral TCD,extracranial carotid arteries ultrasound and DSA,which were compaired with each other in order to identify the value of the former.Methods Conventional CT, MRI,and DWI were performed and analyzed on feature of imaging in patients after the onset of stroke,cerebral TCD on intracranial arteries flow, extracranial carotid arteries ultrasound on atherosclerotic plaque,stenosis or occlusion; DSA on intracranial and extracranial carotid arteries stenosis and value of collateral circulation;Compaired with DSA,we explore the sensitivity and specificity of DWI ＋TCD＋CAU. Results DWI ＋TCD＋CAU had sensitivity of 90.7% with specificity of 90.9%,compaired with DSA. Conclusion DWI combined with cerebral TCD and extracranial carotid arteries ultrasound.conduce to CISS.

关 键 词：急性脑梗死 磁共振弥散加权成像 经颅彩色多普勒 颈动脉超卢检查 中国缺血性卒中亚型 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R741.04[医药卫生—临床医学]