磁共振血管造影联合经颅多普勒超声诊断烟雾病患儿的价值  

Value of magnetic resonance angiography combined with transcranial Doppler sonography in the diagn-osis of children with moyamoya disease

作　　者：魏鑫[1] 刘娟[1] 李明洋 Wei Xin;Liu Juan;Li Mingyang(Transcranial Doppler Room,Children′s Hospital Affiliated to Zhengzhou University(Henan Children′s Hospital,Zhengzhou Children′s Hospital),Henan 450000,China)

机构地区：[1]郑州大学附属儿童医院(河南省儿童医院郑州儿童医院)经颅多普勒室,450000

出　　处：《实用医技杂志》2022年第5期487-490,共4页Journal of Practical Medical Techniques

摘　　要：目的探究磁共振血管造影(MRA)联合经颅多普勒超声(TCD)检查在烟雾病(MMD)患儿诊断中的应用价值。方法选取2017年5月至2020年1月我院收治确诊的35例烟雾病患儿(70侧血管),均行MRA、TCD检查,统计MRA、TCD检查结果,比较MRA、TCD单独,联合诊断烟雾病血管狭窄程度的准确度及诊断烟雾病分类的准确度,并分析MRA、TCD评估烟雾病患儿的脑血流动力学特征。结果本组共35例烟雾病的70侧血管,其中13侧血管正常,26侧血管狭窄,31侧血管闭塞;MRA与TCD联合诊断烟雾病血管狭窄程度的准确度(97%)大于二者单独诊断的准确度(76%与66%)(P<0.05);20例患儿为第1类(Ⅰ期1例,Ⅱ期6例,Ⅲ期13例),15例患儿为第2类(Ⅳ期10例,Ⅴ期4例,Ⅵ期1例),MRA与TCD联合诊断烟雾病分类的准确度(91%)大于二者单独诊断的准确度(71%与66%)(P<0.05)。结论MRA、TCD检查在烟雾病患儿诊断中均具有较高应用价值,二者联合能显著提高烟雾病血管狭窄程度及烟雾病分类的诊断准确度,且能更全面反映患儿血流动力学特征,可为烟雾病的筛查及辅助诊断提供参考。Objective This study aimed to explore the application value of magnetic resonance angiography(MRA)+transcranial Doppler(TCD)sonography in the diagnosis of children with moyamoya disease(MMD).Methods A total of 35 children with MMD(70 blood vessels)admitted to our hospital from May 2017 to January 2020 were enrolled and underwent MRA and TCD examinations.The accuracy of MMD vascular stenosis and MMD classification were determined,and the cerebral hemodynamic characteristics of MRA and TCD in children with MMD were analysed.Results A total of 35 patients with MMD had 70 vessels in this group:13 vessels were normal,26 vessels were stenotic,and 31 vessels were occluded.The accur-acy(97.14%)of combined MRA and TCD sonography in the diagnosis of the degree of vessel stenosis in MMD was higher than that of the two methods alone.The accuracy was 75.71%vs 65.71%(P<0.05);20 children were in class 1(1 in stageⅠ,6 in stageⅡ,and 13 in stageⅢ),and 15 were in class 2(10 in stageⅣ,4 in stageⅤ,and 1 in stageⅥ).The combined accuracy of MRA and TCD sonography in the determination of MMD classification(91%)was significantly higher than that of the two methods alone(71%and 66%)(P<0.05).Conclusion MRA and TCD examinations have high application value in the diagnosis of children with MMD.Their combination can significantly improve the degree of MMD vascular stenosis and diagnostic accuracy of MMD classification and comprehensively reflect the hemodynamic characteristics of children.It can provide accurate data reference for the screening and auxiliary diagnosis of MMD.

关 键 词：脑底异常血管网病 磁共振成像 超声检查 多普勒 经颅 诊断 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]