重新定义TIA的临床和磁共振弥散加权成像的研究.pdfVIP

·148 · Stroke and Nervous Diseases， Jun 2008，Vo1．1 5，No．3 重新定义TIA的临床和磁共振 弥散加权成像的研究 杜敢琴 孙圣刚 黄丽娜 富奇志 孙聚宝 宋海乔 【摘要】 目的 通过研究短暂性脑缺血发作(transient ischemic attack，TIA)的临床特征及其与磁共振 弥散加权成像(Diffusion-Weighted MRI，DWI)异常改变的关系，进一步探讨TIA新定义在临床中的应用价 值。方法 以2006年4月~2007年9月在本院住院的TIA患者为研究对象，入选患者完成MRI检查，前瞻 性收集其临床资料和检查结果，并分析临床特征与DWI异常的关系。结果 共76例TIA患者入选，其中33 例(43 )患者DWI异常(阳性)；22例症状持续≥1 h的患者中有19例DWI阳性(86 )；症状持续≥1 h、有 失语、运动障碍的患者DWI阳性率高(P0．05)；33例DWI阳性的患者中22例常规MRI也发现相关病灶， 但8例是经回顾分析才发现。结论 将近一半的TIA患者DWI有急性缺血性病灶；症状持续≥1 h、失语和 运动障碍与DWI异常有关；新定义有助于TIA的早期评估和治疗，但其部分受限于对影像学检查的依赖。 【关键词】 短暂性脑缺血发作 核磁共振成像 弥散加权 【中图分类号1 R743．31 R445．2 【文献标识码】 A 【文章编号1 1007—0478(2008)03—0148—04 Reappraise the new definition of TIA with clinical characteristics and Diffusion-Weighted MRI in TIA pa— tients Du C~nqin，Sun Shenggang，Huang Lina，et a1．Department of Neurology，Union Hospital，Tong i Medical College，Hua Zhong University of Science and Technology，Wuhan 430022 [Abstract] Objective To assess the clinical characteristics in transient ischemic attack patients and its correlation with Diffusion-Weighted MRI(DWI)abnormolities and further evaluated the clinical application of new defination for TI八 Methods A prospective analysis was performed on all TIA patients who had a MRI scan after symptom onset and entered to hospital during April 2006——September 2007．The relationship be— tween patientsclinical presentation and DWI abnormalities was analyzed．Results DWI detected abnorm alities were present in 33 of 76 cases(43 )．Nineteen of the 22 patients with symptoms lasting equal to or more than 1 hour had DWI lesions．Patients with positive DWI scans were more likely to have sym tom duration equal to or more than 1 hour and to have more，aphas