磁共振血管成像用于急性缺血性脑卒中侧支循环代偿及预后评估的价值  

The value of magnetic resonance angiography in collateral circulation compensation and prognosis evaluation of acute ischemic stroke

作　　者：刘建华 魏美平 刘春岐 LIU Jianhua;WEI Meiping;LIU Chunqi(Department of Radiology,People's Hospital of Hekou District,Dongying,Shandong,257200,China)

机构地区：[1]东营市河口区人民医院影像科,山东东营257200

出　　处：《当代医学》2023年第6期31-34,共4页Contemporary Medicine

摘　　要：目的分析磁共振血管成像(MRA)用于急性缺血性脑卒中侧支循环代偿和预后评估的价值。方法选取2019年6月至2020年6月于本院就诊的90例急性缺血性脑卒中患者作为研究对象,均行MRA检查和计算机断层扫描血管造影(CTA)检查,根据入院72 h、治疗2周后美国国立卫生研究院卒中量表(NIHSS)评分差值分为观察组(n=30,差值>4分为预后良好)与对照组(n=60,差值≤4分为预后一般)。比较两组临床疗效,分析急性缺血性脑卒中预后良好的预测因子,比较CTA和MRA诊断前后循环阳性对急性缺血性脑卒中的诊断效能。结果两组性别、年龄、高血压、糖尿病、冠心病、心力衰竭、吸烟情况、饮酒情况、梗死部位比较差异无统计学意义;观察组ASPECTS评分高于对照组,Willis分级优于对照组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,Willis分级和ASPECTS评分是急性缺血性脑卒中预后良好的预测因子(P<0.05)。CTA与MRA诊断前后循环灵敏度、特异度和准确率比较差异有统计学意义(P<0.05);进一步两两比较:CTA诊断前循环与CTA诊断后循环的灵敏度、特异度和准确率比较差异无统计学意义;MRA诊断前循环与MRA诊断后循环灵敏度、特异度和准确率比较差异无统计学意义;MRA诊断前后循环的灵敏度、特异度和准确率均高于CTA诊断前后循环,差异有统计学意义(P<0.05)。结论予以急性缺血性脑卒中患者MRA检查,可准确评估患者侧支循环情况,也可预测患者预后情况。Objective To evaluate the value of magnetic resonance angiography(MRA)for collateral circulation compensation and prognosis evaluation of acute ischemic stroke.Methods 90 patients with acute ischemic stroke admitted to our hospital from June 2019 to June 2020 were selected as the research subjects,all patients underwent MRA and computed tomography angiography(CTA)examination,they were divided into the observation group(n=30,the difference>4 was defined as good prognosis)and the control group(n=60,the difference≤4 was defined as fair prognosis)according to the difference of National Institutes of Health stroke scale(NIHSS)score at 72 h after admission and 2 weeks after treatment.The clinical efficacy was compared between the two groups,the predictive factors of good prognosis of acute ischemic stroke were analyzed,and the diagnostic efficacy of anterior and posterior circulation diagnosed by CTA and MRA for acute ischemic stroke were compared.Results There were no significant differences in gender,age,hypertension,diabetes,coronary heart disease,heart failure,smoking,drinking and infarct location between the two groups;the ASPECTS score in the observation group was higher than that in the control group,and the Willis classification was better than that in the control group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that Willis classification and ASPECTS score were predictive factors of good prognosis of acute ischemic stroke(P<0.05).There were significant differences in sensitivity,specificity and accuracy between CTA and MRA in the diagnosis of anterior and posterior circulation(P<0.05);further pairwise comparison showed that there was no significant difference in the sensitivity,specificity and accuracy between the diagnosis of anterior circulation and posterior circulation of CTA;there was no significant difference in the sensitivity,specificity and accuracy between the diagnosis of anterior circulation and posterior circulation of MRA;the sensitivity,specif

关 键 词：磁共振血管造影 急性缺血性脑卒中 侧支循环 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]