老年人椎基底动脉缺血性眩晕的MRI、TCD与临床研究  

MRI,TCD and Clinical Study of Vertebrobasilar Artery Ischemic Vertigo of the Elderly

作　　者：李值慧 蔡春洁 卫家耆 LI Zhihui;CAI Chunjie;WEI Jiaqi(Ya'an Vocational and Technical College,Ya'an,Sichuan,625000;Ya'an Vocational and Technical College Affiliated Hospital,Ya'an,Sichuan,625000)

机构地区：[1]雅安职业技术学院,四川雅安625000 [2]雅安职业技术学院附属医院,四川雅安625000

出　　处：《智慧健康》2022年第18期5-7,11,共4页Smart Healthcare

摘　　要：目的探讨磁共振成像(MRI)以及经颅多普勒超声(TCD)对老年人椎基底动脉缺血性头晕的诊断价值。方法对我院2019年1月-2020年6月收治的43例老年椎基底动脉缺血性头晕患者进行MRI以及TCD检查,并对相应的研究结果进行分析以及讨论。结果根据MRI结果显示,相关脑区27例未见异常,梗死16例,占37.2%;T1加权低信号,T2加权高信号,大多数是小腔隙性脑梗塞。小脑半球梗塞11例,脑干梗塞9例。TCD结果显示,椎动脉和基底动脉的TCD在高流速下发生了变化。其中,32例(74.42%)检测出椎动脉收缩期血流速度降低,28例(65.12%)检测出基底动脉收缩期血流速度降低,7例(16.28%)检测出椎动脉收缩期血流高流速降低,有12例(27.90%)检测出基底动脉高流速。结论老年人椎体基底缺血性头晕的MRI具有较高的分辨率,并且可以获取所有横截面的3D图像,从而导致骨骼伪影,可以清楚地显示后颅窝区域的病变。这样可以及时诊断过去常常被忽略或误诊的小脑以及脑干梗塞。可以将其用作诊断测试,以确定椎基底动脉供血不足的患者是否有脑梗塞,但MRI没有显示出器质性血管,通常会使诊断变得困难。TCD检测简单、方便,是有效的检测老年人椎基底动脉缺血性头晕的方法,具有重要的诊断价值。Objective To investigate value of magnetic resonance imaging(MRI)and transcranial Doppler(TCD)in diagnosis of vertebrobasilar ischemic dizziness of the elderly.Methods The paper chose 43 elderly patients with vertebrobasilar artery ischemic dizziness treated in our hospital from January 2019 to June 2020 with MRI and TCD,corresponding research results were analyzed and discussed.Results According to results of MRI,there were no abnormalities in 27 cases of related brain areas,and 16 cases of infarction,accounting for 37.2%;T1 weighted low signal,T2 weighted high signal,mostly belonged to small lacunar cerebral infarction.There were 11 cases of cerebellar hemisphere infarction and 9 cases of brainstem infarction.TCD results showed that TCD of vertebral artery and basilar artery changed under high flow velocity.Among them,32 cases(74.42%)showed decreased systolic blood flow velocity of vertebral artery,28 cases(65.12%)showed decreased systolic blood flow velocity of basilar artery,7 cases(16.28%)showed decreased high systolic blood flow velocity of vertebral artery,and 12 cases(27.90%)showed high systolic blood flow velocity of basilar artery.Conclusion MRI of vertebrobasilar ischemic dizziness of elderly has high resolution,can obtain 3D images of all cross sections,show lesions in posterior fossa area clearly with bone artifacts.It can diagnose cerebellar and brainstem infarction in time,which was often neglected or misdiagnosed in the past, which can be diagnostic test to determine whether patients with vertebrobasilar insufficiency havecerebral infarction, and MRI does not show organic vessels, which usually makes diagnosis difficult.TCD detection is simple and convenient, and be an effective method to detect vertebrobasilar ischemicdizziness of the elderly, and has important diagnostic value.

关 键 词：老年人 椎基底动脉缺血性头晕 MRI TCD 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]