磁共振血管成像、弥散加权成像联合颈部血管彩超评价分水岭脑梗死的临床意义  

Clinical significance of MRA,DWI combined with carotid duplex ultrasound in the evaluation of watershed cerebral infarction

作　　者：郑宾 郑永洁 马宏武 Zheng Bin;Zheng Yongjie;Ma Hongwu(Department of Neurology,Dafeng Hospital of Chaoyang District,Shantou 515154,China)

机构地区：[1]汕头市潮阳区大峰医院神经内科,广东汕头515154 [2]汕头市潮阳区大峰医院肿瘤内科,广东汕头515154

出　　处：《海军医学杂志》2024年第8期823-826,共4页Journal of Navy Medicine

基　　金：汕头市科技计划医疗卫生类别项目(210701116491036)。

摘　　要：目的探讨磁共振血管成像(MRA)、弥散加权成像(DWI)联合颈部血管彩超评价分水岭脑梗死的临床意义。方法收集并分析2021年7月至2022年12月汕头市潮阳区大峰医院收治的164例脑梗死患者的临床资料,根据脑梗死部位分为对照组(n=82,非分水岭脑梗死患者)与研究组(n=82,分水岭脑梗死患者)。所有患者均接受MRA、DWI、颈部血管彩超检查,对比2组MRA、DWI、颈部血管彩超特征,绘制受试者操作特征(ROC)曲线,以曲线下面积(AUC)评估MRA、DWI联合颈部血管彩超对分水岭脑梗死的诊断价值。结果观察组大脑中动脉中度及以上狭窄例数占比高于对照组(P<0.05)。观察组部分各向异性指数(rFA)高于对照组(P<0.05),平均扩散率指数(rMD)低于对照组(P<0.05)。观察组颈动脉斑块例数占比高于对照组(P<0.05)。ROC曲线结果显示,MRA、DWI、颈部血管彩超及三者联合诊断分水岭脑梗死的AUC值分别为0.774、0.677、0.732、0.884,且三者联合诊断的AUC值高于单独指标诊断的AUC值(P<0.05)。结论MRA、DWI、颈部血管彩超在诊断分水岭脑梗死中具有重要价值,三者联合的诊断价值更高。Objective To investigate the clinical significance of magnetic resonance angiography(MRA),diffusion weighted imaging(DWI)combined with carotid duplex ultrasound in evaluating watershed cerebral infarction.Methods The clinical data of 164 patients with cerebral infarction who were admitted to Dafeng Hospital of Chaoyang District from July 2021 to December 2022 were collected and analyzed.According to the location of cerebral infarction,the patients were divided into control group(n=82,nonwatershed cerebral infarction)and study group(n=82,watershed cerebral infarction).All the patients were received MRA,DWI and carotid duplex ultrasound.The characteristics of MRA,DWI and carotid duplex ultrasound were compared between the two groups.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was used to evaluate the diagnostic value of MRA and DWI combined with carotid duplex ultrasound for watershed cerebral infarction.Results The proportion of patients with moderate and above middle cerebral artery stenosis in the observation group was higher than that in the control group(P<0.05).The partial anisotropy index(rFA)of the observation group was higher than that of the control group(P<0.05),and the mean diffusion index(rMD)of the observation group was lower than that of the control group(P<0.05).The proportion of patients with carotid plaques in the observation group was higher than that in the control group(P<0.05).The AUC values of MRA,DWI,carotid duplex ultrasound and their combination for the diagnosis of watershed cerebral infarction were 0.774,0.677,0.732 and 0.884,respectively.The AUC value of the combined diagnosis of the three tests was higher than that of the single diagnosis(P<0.05).Conclusion MRA,DWI and carotid duplex ultrasound have important value in the diagnosis of watershed cerebral infarction,and their combined value is even higher.

关 键 词：磁共振血管成像 弥散加权成像 颈部血管彩超 分水岭脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]