MRI联合CT血管造影预测后循环梗死的效能研究  

Study on the efficacy of MRI combined with CT angiography in predicting posterior circulatory infarction

作　　者：孟祥 邵福明 宋传顺 张艳辉[2] 郭栋 代斌 李晨晨 彭彬 邵艳 曹银平 MENG Xiang;SHAO Fuming;SONG Chuanshun;ZHANG Yanhui;GUO Dong;DAI Bin;LI Chenchen;PENG Bin;SHAO Yan;CAO Yinping(shangqiu Central Hospital,Shangqiu 476600,China;Shangqiu Medical College,Shangqiu 476000,China)

机构地区：[1]商丘市中心医院,河南商丘476600 [2]商丘医学高等专科学校,河南商丘476000

出　　处：《中国实用神经疾病杂志》2021年第22期1964-1975,共12页Chinese Journal of Practical Nervous Diseases

基　　金：河南省高等学校重点科研项目(编号:15B320008)。

摘　　要：目的探讨磁共振成像(MRI)+CT血管造影(CTA)评估基底动脉脑桥水平直径、两侧椎动脉直径比、钙化灶直径与基底动脉发育不全(BAH)患者眩晕程度的关系及预测后循环梗死的效能。方法选取2017-05—2020-03商丘市中心医院收治的70例BAH后循环梗死患者(观察组)及70例单纯BAH患者(对照组),比较2组一般资料、眩晕程度、MRI+CTA参数(基底动脉脑桥水平直径、两侧椎动脉直径比、钙化灶直径),采用Spearman分析MRI+CTA参数与眩晕程度的关系,采用Logistic回归方程分析BAH后循环梗死的影响因素,并比较观察组不同预后患者MRI+CTA参数,采用受试者工作特征曲线(ROC)分析MRI+CTA参数预测后循环梗死及预后的效能。结果 2组高脂血症、糖尿病、高血压患者占比及眩晕程度比较,差异有统计学意义(P<0.05);观察组基底动脉脑桥水平直径低于对照组,两侧椎动脉直径比、钙化灶直径高于对照组(P<0.05);基底动脉脑桥水平直径与眩晕程度呈负相关,两侧椎动脉直径比、钙化灶直径与眩晕程度呈正相关(P<0.05);高脂血症、糖尿病、高血压、眩晕程度、基底动脉脑桥水平直径、两侧椎动脉直径比、钙化灶直径均与BAH后循环梗死显著相关(P<0.05);基底动脉脑桥水平直径、两侧椎动脉直径比、钙化灶直径参数值联合检测预测后循环梗死的AUC值为0.876,预测后循环梗死预后的AUC值为0.917,均大于任一参数值单独检测。结论 MRI联合CTA检查可通过评价基底动脉发育情况为临床诊断BAH患者眩晕程度、预测后循环梗死风险及预后病情转归提供参考,便于临床早期完善治疗方案,改善预后。Objective To investigate magnetic resonance imaging(MRI)+CT angiography(CTA)to evaluate the relationship between the horizontal diameter of the basilar artery pons,the ratio of the bilateral vertebral artery diameters,the diameter of calcification foci,and the degree of vertigo in patients with basilar artery hypoplasia(BAH)and the effectiveness of predicting posterior circulation infarction.Methods From May 2017 to March 2020,70 patients with retrocirculatory infarction of BAH(observation group)and 70 patients with simple BAH (control group)who were admitted to our hospital from May 2017 to March 2020 were selected. The general data,the degree of vertigo,MRI+CTA parameters(basal artery and pons horizontal diameter,ratio of vertebral artery diameters on both sides,diameter of calcification lesions)were compared between the two groups. Spearman was used to analyze the relationship between MRI+CTA parameters and the degree of vertigo,and the logistic regression equation was used to analyze the influencing factors of circulatory infarction after BAH. The MRI+CTA parameters of patients with different prognosis in the observation group were compared,and receiver operating characteristic curve(ROC)was used to analyze the efficacy of MRI + CTA parameters in predicting posterior circulation infarction and prognosis.Results The difference in the proportion of patients with hyperlipidemia,diabetes,and hypertension and the degree of dizziness between the two groups was statistically significant(P<0.05). The horizontal diameter of the basilar artery pons in the observation group was lower than that in the control group,and the ratio of vertebral artery diameters on both sides and the diameter of calcification foci were higher than those in the control group(P<0.05). The horizontal diameter of the basilar artery pons was negatively correlated with the degree of vertigo,and the ratio of the bilateral vertebral artery diameters and the diameter of the calcification foci were positively correlated with the degree of vertigo(P<0.

关 键 词：磁共振成像 CT血管造影 钙化灶直径 基底动脉发育不全 受试者工作特征曲线 眩晕程度 

分 类 号：R743.33[医药卫生—神经病学与精神病学]