脑干弥散加权成像联合经颅多普勒超声检查椎-基底动脉狭窄的诊断效能分析  

Analysis of the diagnostic efficiency of brainstem DWI combined with TCD on vertebral-basilar artery stenosis

作　　者：孙佯 李海英 郭艳强 郑嘉荣 SUN Yang;LI Hai-ying;GUO Yan-qiang(Department of Ultrasound Medicine,Hebei Yanda Hospita,Langfang 065201,China)

机构地区：[1]河北燕达医院超声医学科,河北廊坊065201 [2]河北燕达医院神经内科,河北廊坊065201

出　　处：《中国医学装备》2022年第4期76-80,共5页China Medical Equipment

摘　　要：目的:探讨脑干磁共振弥散加权成像(DWI)评分与经颅多普勒超声(TCD)在椎-基底动脉狭窄诊断中的应用价值。方法:选取医院收治并经脑磁共振血管成像(MRA)确诊的89例急性脑干梗死患者,且均行头部DWI及TCD检查。采用单因素方差分析及Spearman相关性分析,比较不同患者椎-基底动脉狭窄程度DWI评分及相关性;采用受试者工作特征(ROC)曲线下面积(AUC)评估脑干DWI与经颅多普勒超声单一检查及两种方法联合检查的诊断效能。结果:在89例患者中经MRA检测到椎-基底动脉260条,其中正常129条,狭窄131条。131条狭窄的椎-基底动脉中轻度狭窄54条,中度狭窄37条,重度狭窄30条,闭塞10条。不同患者椎-基底动脉狭窄程度DWI评分差异有统计学意义(χ^(2)=32.06,P<0.05);DWI评分与椎-基底动脉狭窄程度呈正相关(r=0.597,P<0.05)。正常动脉收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、平均血流速度(MFV)及搏动指数(PI)值均显著低于狭窄动脉,且闭塞动脉PSV、EDV、MFV及PI值均显著高于重度、中度及轻度狭窄动脉,差异有统计学意义(F=135.02,F=55.02,F=85.31,F=26.30;P<0.01)。椎-基底动脉狭窄程度与PSV、EDV、MFV及PI值均呈正相关性(r=0.720,r=0.524,r=0.579,r=0.651;P<0.05)。脑干DWI联合TCD诊断AUC显著高于TCD、DWI单一诊断,差异有统计学意义(Z=4.214,Z=3.915;P<0.05)。结论:脑干DWI联合TCD可以提升椎-基底动脉狭窄的诊断效能,具有临床应用价值。Objective:To explore the application value of brainstem diffusion weighted imaging(DWI)score and transcranial Doppler(TCD)in the diagnosis of vertebral-basilar artery stenosis.Methods:89 patients with acute brainstem infarction who were confirmed by magnetic resonance angiography(MRA)on cerebra were retrospectively selected.Among them,and all the 89 patients underwent both DWI and TCD examination.One-way analysis of variance and Spearman correlation analysis were adopted to compare the degree of vertebral-basilar artery stenosis of patients with different DWI score and to conduct correlation analysis.The area under curve(AUC)of receiver operating characteristics(ROC)curve was adopted to assess the diagnostic efficiencies of DWI,TCD and the combined examination of them.Results:260 vertebral-basilar arteries of 89 patients were found by MRA examination,and 129of them were normal while 131 of them were stenosis.In 131 vertebral–basilar arteries with stenosis,54 cases were mild stenosis,and 37 cases were moderate stenosis,and 30 cases were severe stenosis and 10 cases were occlusion.The differences of the stenosis degrees of vertebral-basilar artery of patients with different DWI scores were significant(χ^(2)=32.06,P<0.05).The results of Spearman correlation analysis showed that DWI score was positively correlative with the degree of vertebral-basilar artery stenosis(r=0.597,P<0.05).The values of peak systolic velocity(PSV)of systole stage,end diastolic velocity(EDV),mean flow velocity(MFV)and pulsatility index(PI)in the normal arteries were significantly lower than those in the stenosis arteries,and the values of PSV,EDV,MFV and PI in the occlusive arteries were significantly higher than those in the arteries with severe,moderate and mild stenosis,respectively(F=135.02,F=55.02,F=85.31,F=26.30,P<0.05).The results of Spearman correlation analysis also showed that the degrees of the stenosis of vertebral-basilar arteries was positively correlative with PSV,EDV,MFV and PI(r=0.720,r=0.524,r=0.579,r=0.651,P<0.05),respe

关 键 词：急性脑干梗死 磁共振成像(MRI) 弥散加权成像(DWI) 经颅多普勒超声(TCD) 椎-基底动脉狭窄 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]