DWI联合MRA在短暂性脑缺血发作中的应用价值

目的：探讨磁共振弥散加权成像（DWI）联合颅颈血管造影（MRA）在短暂性脑缺血发作（TIA）中的临床应用价值。方法：选择经临床和影像学确诊TIA患者72例为TIA组，均在发病1周内行颅脑DWI和颅颈部MRA检查；随机选择同期健康体检者36名为正常组，对两组进行对比。结果：TIA组与正常组在颅颈动脉狭窄程度和狭窄数量上具有显著性差异（t=12.316，P＜0.01）。TIA组颅颈动脉狭窄及闭塞增多。椎基底动脉TIA患者单侧椎动脉发育不良比例增高。TIA患者DWI上均未见新鲜缺血灶，6例病情进展患者DWI上出现高信号，诊断为脑梗死。结论：颅脑DWI是鉴别TIA及脑梗死的简单有效检查手段，而MRA可明确颅颈动脉狭窄位置及严重程度， DWI联合MRA对TIA患者的病因诊断及其继发脑梗死的风险评估具有重大临床价值。

Combine diffusion-weighted imaging and magnetic resonance angiography in the diagnosis of transient ischemic attacks

Objective：To study the value in clinical application of diffusion weighted imagine （DWI） and magnetic resonance angiography （MRA） in transient ischemic attacks （TIA）. Methods：A totle of 72 patients diagnose as TIA by clinical manifestation and medical imaging, Brain DWI and brain and carotid MRA were underwent in the disease within a week. 36 healthy checkup people were randomly chosen as control subjects. The differences of sex and age of two groups have no statistical significance （P＆gt;0.05）. Results：There were significant differences among the two groups in the degree and the number of stenosis of cranial and cervical arteries （t=12.316, P＆lt;0.01）. The stenosis and occlusion of arteries were severe in the patients with TIA than that in healthy adults. The incidence of dysplasia of unilateral vertebral arteries （VA） in TIA was higher than that in the normal subjects. the patients with TIA don’t all display fresh focal ischemia on DWI. 6 case patients of disease progression happen cerebral infarction display abnormally high signal on DWI. Conclusion：Brain DWI is an simply and effective way to identify TIA and cerebral infarction. MRA can show the location and the degree of stenosis of cranial and cervical arteries. DWI combined MRA has great value for etiological diagnosis of TIA and the risk assessment of cerebral infarction.