颈内动脉系统短暂性脑缺血发作临床与TCD及MRI的对比分析  

A Contrastive Analysis on Clinic Manifestation and TCD and MRI Results in Transient Ischemic Attack of Internal Carotid Artery System

作　　者：周琳[1] 刘晓英[1] 叶海翠[1] 谷文萍[1] 杨期东[1] 

机构地区：[1]中南大学湘雅医院神经内科,湖南长沙410008

出　　处：《中国医师杂志》2003年第8期1014-1016,共3页Journal of Chinese Physician

基　　金：中央保健局资助课题 (湘C0 0 1 )

摘　　要：目的　探讨TCD和MRI在颈内动脉系统TIA中的诊断价值。方法　对 66例颈内动脉系统TIA患者的临床与TCD及MRI的结果作对比分析 ,采用 χ2 检验。结果　发现颈内动脉系统TIA患者发作间期 60例 ( 90 9%)脑内动脉存在着广泛的血流动力学改变 ,2 4例 ( 4 2 4%)症状相应侧动脉均有不同程度的狭窄 ,头颅MRI检查发现 5 0例 ( 75 8%)有梗塞灶 ,3 5例 ( 5 3 5 %)有脑白质疏松症 ,病灶多呈双侧分布 ,较对称 ,症状与病灶无明显相关性。MRI有无梗塞灶与TCD阳性率无明显差异性 (P >0 0 5 ) ,MRI有无梗塞灶的症状相应侧动脉狭窄改变情况亦无显著性差异 ( P >0 0 5 )。结论　TCD能了解颈内动脉系统TIA患者血管情况 ,可作为常规和初筛检查。脑MRI对颈内动脉系统TIA可能无特别临床意义 ,但对TIA临床亚型Objective To study the diagnostic value of TCD and MRI in transient ischemic attack (TIA) of internal carotid artery system.Methods The clinic data was analyzed to contrast the relation of the clinic manifestation and the TCD and MRI results of 66 patients suffered from TIA of the internal carotid artery system.then chi-square test was adopted.Results In TIA interval, extensive hemodynamics changes were occurred in the intracranial arteries among 60 patients(90 9%), and 22 patients(33 3) presented different degrees of stricture on the corresponding symptom side, MRI test showed lacunar infarct or small infarct foci among 50 patients(75 8%), and ischemic leukoenporosis among 35 patients(53 5%). But the foci took a two-side distribution and were relatively symmetrical. No significant correlation existed between the symptom and the foci,and the positive rate of TCD did not show remarkable difference between the symptoms and the foci, and the positive ratio of TCD did not show remarkable difference whether the MRI infarct foci existed or not. Meanwhile, there were also no notable distinction between the stricture change of arteries in the corresponding symptom side with the infarct foci and that of arteries in the corresponding symptom side without the infarct foci.Conclusions TCD can find the change of arteries related in TIA of the internal carotid artery system, and can be used as routine and primary screening. While MRI may bear no special clinic significance to TIA of the internal carotid artery system, but it has localization meaning to CWS, a clinical subtype of TIA.

关 键 词：短暂性脑缺血发作 经颅多普勒超声波 磁共振成像 内囊警示综合征 

分 类 号：R743.3[医药卫生—神经病学与精神病学]