中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2014年
10期
722-726
,共5页
朱珠%葛亮%韩翔%沈筠筠%汤伟军%张晓龙%董强
硃珠%葛亮%韓翔%瀋筠筠%湯偉軍%張曉龍%董彊
주주%갈량%한상%침균균%탕위군%장효룡%동강
颈内动脉破裂%椎动脉破裂%磁共振成像%体层摄影术,X线计算机
頸內動脈破裂%椎動脈破裂%磁共振成像%體層攝影術,X線計算機
경내동맥파렬%추동맥파렬%자공진성상%체층섭영술,X선계산궤
Carotid artery,internal,dissection%Vertebral artery dissection%Magnetic resonance imaging%Tomography,X-ray computed
目的 探讨自发性颈内动脉夹层(sICAD)与自发性椎动脉夹层(sVAD)较敏感的影像学诊断方法,以期有助于提高临床早期诊断率.方法 收集复旦大学附属华山医院2008年1月至2013年7月连续收治的sICAD及sVAD患者88例,行CT血管成像(CTA)、磁共振脂肪抑制序列(T1-FS)及数字减影血管造影(DSA)等影像学检查,并分别分析不同影像学检查方法对诊断sICAD及sVAD的敏感度.结果 共纳入患者80例,其中男性62例,女性18例,年龄(45.7±11.9)岁.共99处动脉夹层病变,sICAD 45例,sVAD 52例,大脑中动脉夹层2例.CTA、DSA、磁共振T1-FS诊断sICAD的敏感度分别为97.5％(39/40)、90.0％ (36/40)和69.6％(16/23),而对sVAD的诊断敏感度分别为89.8％ (44/49)、84.6％ (44/52)和100.0％(27/27).结论 不同检查方法对sICAD与sVAD诊断价值各异.CTA和磁共振T1-FS分别对诊断sICAD及sVAD具有较高敏感度,而DSA虽为诊断血管病变的“金标准”,却因对血管壁情况显示存在缺陷,亦有漏诊可能,结合CTA和磁共振T1-FS将有望提高诊断敏感度.
目的 探討自髮性頸內動脈夾層(sICAD)與自髮性椎動脈夾層(sVAD)較敏感的影像學診斷方法,以期有助于提高臨床早期診斷率.方法 收集複旦大學附屬華山醫院2008年1月至2013年7月連續收治的sICAD及sVAD患者88例,行CT血管成像(CTA)、磁共振脂肪抑製序列(T1-FS)及數字減影血管造影(DSA)等影像學檢查,併分彆分析不同影像學檢查方法對診斷sICAD及sVAD的敏感度.結果 共納入患者80例,其中男性62例,女性18例,年齡(45.7±11.9)歲.共99處動脈夾層病變,sICAD 45例,sVAD 52例,大腦中動脈夾層2例.CTA、DSA、磁共振T1-FS診斷sICAD的敏感度分彆為97.5％(39/40)、90.0％ (36/40)和69.6％(16/23),而對sVAD的診斷敏感度分彆為89.8％ (44/49)、84.6％ (44/52)和100.0％(27/27).結論 不同檢查方法對sICAD與sVAD診斷價值各異.CTA和磁共振T1-FS分彆對診斷sICAD及sVAD具有較高敏感度,而DSA雖為診斷血管病變的“金標準”,卻因對血管壁情況顯示存在缺陷,亦有漏診可能,結閤CTA和磁共振T1-FS將有望提高診斷敏感度.
목적 탐토자발성경내동맥협층(sICAD)여자발성추동맥협층(sVAD)교민감적영상학진단방법,이기유조우제고림상조기진단솔.방법 수집복단대학부속화산의원2008년1월지2013년7월련속수치적sICAD급sVAD환자88례,행CT혈관성상(CTA)、자공진지방억제서렬(T1-FS)급수자감영혈관조영(DSA)등영상학검사,병분별분석불동영상학검사방법대진단sICAD급sVAD적민감도.결과 공납입환자80례,기중남성62례,녀성18례,년령(45.7±11.9)세.공99처동맥협층병변,sICAD 45례,sVAD 52례,대뇌중동맥협층2례.CTA、DSA、자공진T1-FS진단sICAD적민감도분별위97.5％(39/40)、90.0％ (36/40)화69.6％(16/23),이대sVAD적진단민감도분별위89.8％ (44/49)、84.6％ (44/52)화100.0％(27/27).결론 불동검사방법대sICAD여sVAD진단개치각이.CTA화자공진T1-FS분별대진단sICAD급sVAD구유교고민감도,이DSA수위진단혈관병변적“금표준”,각인대혈관벽정황현시존재결함,역유루진가능,결합CTA화자공진T1-FS장유망제고진단민감도.
Objective To investigate the most sensitive methods for diagnosing spontaneous internal carotid artery dissection (sICAD) and spontaneous vertebral artery dissection (sVAD) respectively,for the sake of earlier and more accurate diagnosis.Methods Consecutive patients with sICAD and sVAD who visited the Department of Neurology and Radiology,Huashan Hospital Affiliated to Fudan University during 2008-2013 were retrospectively reviewed and the sensitivity of CT angiography (CTA),magnetic resonance T1-weighted fat-suppressed images (MR T1-FS) and digital subtraction angiography (DSA) for the diagnosis of sICAD and sVAD was compared.Results Eighty patients (62 male,18 female; mean age (45.7 ± 11.9) years) were included in the study.There were 99 arterial dissections in total,45 cases of sICAD,52 cases of sVAD and 2 cases of spontaneous middle cerebral artery dissections.The sensitivity of CTA,DSA and MR T1-FS for diagnosing sICAD was 97.5％ (39/40),90.0％ (36/40) and 69.6％ (16/23) respectively,while for sVAD was 89.8％ (44/49),84.6％ (44/52) and 100.0％ (27/27) respectively.Conclusions sICAD and sVAD have significant differences in many aspects including diagnostic strategies.CTA and MR T1-FS seem to be the most sensitive methods for the diagnosis of sICAD and sVAD respectively.Although DSA has been considered as the gold standard for the diagnosis of artery dissection,this imaging technique does not allow analysis of artery wall thickness,thus also has limitations.It is likely that the diagnostic sensitivity will be improved by combining CTA and MR T1-FS.
