短暂性脑缺血患者核磁共振弥散成像的应用价值

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目的观察核磁共振弥散成像对短暂性脑缺血患者的临床诊断的应用意义。方法选取54例TIA患者,在发病6h内均使用DWI、CT和DSA进行检查。结果 24hDWI阳性患者中,出现脑血栓现象的有27例,TIA现象的有6例,并在24h内恢复。DWI阴性有3例为脑血栓,其他18例均表现为TIA。CT检出8例异常,其中,多发性大脑深部病变2例,单发性大脑深部病变5例,单发枕叶浅部病变1例。DSA检查显示单支动脉狭窄者有15例,多支动脉狭窄者有30例,未发现血管狭窄者9例。结论 DWI能够早期区别TIA和脑梗死;CT早期检查率较低;DSA能准确之处血管狭窄和闭塞程度,有利于明确堵塞血管位置,但其有创伤性,临床操作较复杂,不能作为常用的临床检查TIA手段。故DWI在短暂性脑缺血患者检查中具有较高的临床意义。 Objective To observe the clinical significance of diffusion-diffusion imaging in the diagnosis of patients with transient cerebral ischemia. Methods Totally 54 TIA patients were examined with DWI, CT and DSA within 6 hours of onset. Results Among the 24hDWI positive patients, there were 27 cases of cerebral thrombosis and 6 cases of TIA and recovered within 24 hours. Three of the DWI-negative patients had cerebral thrombosis, and the remaining 18 patients showed TIA. CT abnormalities were detected in 8 cases, of which, multiple deep brain lesions in 2 cases, single brain deep lesions in 5 cases, single case of occipital lobelial lesions in 1 case. DSA examination showed that there were 15 cases of single artery stenosis, 30 cases of multiple artery stenosis, 9 cases of vascular stenosis were not found. Conclusion DWI can distinguish TIA and cerebral infarction at an early stage; early detection rate of CT is low; DSA can accurately identify the degree of vascular stenosis and occlusion, which is helpful to clear the occlusion of blood vessel. However, its invasiveness and clinical operation are complicated and can not be used as a common Clinical examination TIA means. Therefore, DWI in patients with transient ischemic examination has a high clinical significance.
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