磁共振血管造影与经颅多普勒超声检查在诊断脑梗死患者颅内动脉狭窄中的价值比较  

Comparison of MRA and TCD in diagnosis of intracranial artery stenosis in patients with cerebral infarction

作　　者：张悦 Zhang Yue(The Liaobu Hospital of Dongguan City,Dongguan,Guangdong 523400)

机构地区：[1]东莞市寮步医院,广东东莞523400

出　　处：《基层医学论坛》2023年第22期97-99,共3页The Medical Forum

摘　　要：目的比较磁共振血管造影(MRA)检查与经颅多普勒超声(TCD)检查在诊断脑梗死患者颅内动脉狭窄中的应用价值。方法纳入2020年6月—2022年2月东莞市寮步医院收治的60例脑梗死患者,所有患者均先接受TCD检查,并于TCD检查后3 d内完成MRA检查。以数字减影血管造影(DSA)检查结果作为诊断“金标准”,分析MRA、TCD在脑梗死患者颅内动脉狭窄中的诊断价值及与DSA诊断的一致性。结果60例患者经DSA检查检出25例颅内动脉狭窄,其中轻度狭窄9例,中度狭窄5例,重度狭窄3例,闭塞8例;经MR A检查检出颅内动脉狭窄共28例,包括轻度狭窄7例,中度狭窄8例,重度狭窄4例,闭塞9例;经TCD检查检出颅内动脉狭窄共24例,包括轻度狭窄8例,中度狭窄4例,重度狭窄2例,闭塞10例。MRA在检查脑梗死患者颅内动脉狭窄中诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为96.00%、88.57%、91.67%、85.71%、96.88%,与TCD检查的76.00%、85.71%、81.67%、79.17%、83.33%比较,差异无统计学意义(P>0.05);Kappa检验显示,MR A检查与DSA检查的一致性良好(Kappa值=0.831,P<0.001),TCD检查与DSA检查的一致性尚可(Kappa值=0.621,P<0.001)。结论MRA与TCD检查在脑梗死患者颅内动脉狭窄诊断中均有较高的应用价值,但MRA检查与DSA诊断一致性更高,可将MRA作为首选影像学方法。Objective To explore the value of magnetic resonance angiography(MRA)and transcranial Doppler ultrasound(TCD)in the diagnosis of intracranial artery stenosis in patients with cerebral infarction.Methods 60 patients with cerebral infarction admitted to our hospital from June 2020 to February 2022 were enrolled.All patients received TCD examination and MRA examination.All patients received TCD examination first,and MRA examination was completed within 3 days after examination.DSA examination was taken as the"gold standard"to analyze the examination results of MRA and TCD,as well as the diagnostic value of MRA and TCD in intracranial arterial stenosis in patients with cerebral infarction,and the consistency between the two examination methods and DSA in the diagnosis of intracranial arterial stenosis in patients with cerebral infarction was calculated.Results 25 cases of intracranial artery stenosis were detected by DSA in 60 patients with cerebral infarction,including mild stenosis in 9 cases,moderate stenosis in 5 cases,severe stenosis in 3 cases and occlusion in 8 cases.MRA examination confirmed 28 cases of intracranial arterial stenosis,including mild stenosis in 7 cases,moderate stenosis in 8 cases,severe stenosis in 4 cases and occlusion in 9 cases.TCD examination confirmed intracranial arterial stenosis in 24 cases,mild stenosis in 8 cases,moderate stenosis in 4 cases,severe stenosis in 2 cases and occlusion in 10 cases.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MRA in intracranial artery stenosis of patients with cerebral infarction were 96.00%,88.57%,91.67%,85.71%and 96.88%,respectively.Compared with 76.00%,85.71%,81.67%,79.17%,83.33%of TCD examination,there was no statistical difference(P>0.05).Kappa test showed good consistency between MRA and DSA(Kappa value=0.831,P<0.001).The consistency between TCD and DSA was good(Kappa value=0.621,P<0.001).Conclusion MRA and TCD have high application value in the diagnosis of intracranial artery stenosis

关 键 词：脑梗死 颅内动脉狭窄 磁共振血管造影 经颅多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]