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目的评估短暂性脑缺血发作(TIA)患者颅颈动脉的磁共振血管造影(MRA)和脑实质的弥散加权成像(DWI)表现。方法选择符合诊断标准的40例TIA患者作为研究对象,并与随机选择的同期34例正常成人及36例脑梗死患者进行对比。分析颅颈部脑供血动脉的狭窄程度及其分布、血管发育状态、脑实质的DWI表现与TIA的关系。结果3组间在颅颈动脉狭窄支数及狭窄程度上存在显著性差异(P=0.006);TIA组及脑梗死组颅颈动脉重度狭窄及闭塞性病变明显增多(P=0.004、0.015),但TIA组与脑梗死组之间无显著性差异(P=0.148)。椎基底动脉系统TIA患者单侧椎动脉(VA)发育不良的比例明显高于正常人(P=0.039)。颈内动脉(ICA)系统TIA患者更容易出现DWI高信号灶(4/8,50.00%)。结论TIA患者颅颈动脉的重度狭窄或闭塞及不规则充盈缺损可能是发生严重缺血性脑卒中的最危险因素之一。VA发育不良是TIA的易感因素之一。
Objective To evaluate the performance of magnetic resonance angiography (MRA) and diffuse weighted imaging (DWI) of brain parenchyma in patients with transient ischemic attack (TIA). Methods Forty patients with TIA who met the diagnostic criteria were selected as the study subjects and compared with 34 randomly selected normal adults and 36 patients with cerebral infarction. To analyze the degree and distribution of cranial and cerebral cerebral artery stenosis, vascular development, brain parenchymal DWI and TIA. Results There were significant differences between the three groups in the number of stenosis and stenosis of cranial carotid artery (P = 0.006). Severe stenosis and occlusive lesions of cranial carotid artery in TIA group and cerebral infarction group were significantly increased (P = 0.004,0.015) However, there was no significant difference between TIA group and cerebral infarction group (P = 0.148). Vertebrobasilar artery TIA patients with unilateral vertebral artery (VA) dysplasia was significantly higher than normal (P = 0.039). Internal carotid artery (ICA) system TIA patients are more prone to DWI high signal stove (4 / 8,50.00%). Conclusion Severe stenosis or occlusion of cranial carotid artery and irregular filling defect in TIA patients may be one of the most dangerous factors in the occurrence of severe ischemic stroke. VA dysplasia is one of the predisposing factors of TIA.