CAJ | 학술논문

目的：探讨颈部血管彩超联合头颅磁共振造影（MRA）对缺血性脑血管病（ICVD）的诊断价值。方法选取脑血栓形成患者92例（A组），短暂性脑缺血发作（T IA ）患者37例（B组）及健康体检者50例作为对照组（C组），分别采用颈部血管彩超诊断；92例脑血栓形成患者中80例同时行头颅M RA检查。比较不同人群动脉粥样硬化的发生率及病变特点，比较两种诊断方法对颈内动脉闭塞诊断的吻合程度。结果颈部血管彩超检查结果表明，A、B组间粥样斑块形成、IM T厚度及软斑形成比较差异无统计学意义（P＞0.05），与C组比较差异均有统计学意义（P＜0.05）；3组颈动脉粥样斑块分布比较差异无统计学意义（P＞0.05）。颈部血管彩超与头颅MRA对颈内动脉闭塞诊断的吻合率87.50％，对椎动脉闭塞诊断的吻合率75.00％，对轻度狭窄、中度狭窄及重度狭窄诊断的吻合率分别92.86％、94.12％及85.71％。结论颈部血管彩超可为ICVD病变患者颈动脉粥样硬化斑块的形成部位、管腔狭窄程度提供诊断依据，头颅M RA可进一步对颅内血管病变进行诊断，两者联合可更全面评价ICVD病变情况，为临床诊治提供参考。
목적：탐토경부혈관채초연합두로자공진조영（MRA）대결혈성뇌혈관병（ICVD）적진단개치。방법선취뇌혈전형성환자92례（A조），단잠성뇌결혈발작（T IA ）환자37례（B조）급건강체검자50례작위대조조（C조），분별채용경부혈관채초진단；92례뇌혈전형성환자중80례동시행두로M RA검사。비교불동인군동맥죽양경화적발생솔급병변특점，비교량충진단방법대경내동맥폐새진단적문합정도。결과경부혈관채초검사결과표명，A、B조간죽양반괴형성、IM T후도급연반형성비교차이무통계학의의（P＞0.05），여C조비교차이균유통계학의의（P＜0.05）；3조경동맥죽양반괴분포비교차이무통계학의의（P＞0.05）。경부혈관채초여두로MRA대경내동맥폐새진단적문합솔87.50％，대추동맥폐새진단적문합솔75.00％，대경도협착、중도협착급중도협착진단적문합솔분별92.86％、94.12％급85.71％。결론경부혈관채초가위ICVD병변환자경동맥죽양경화반괴적형성부위、관강협착정도제공진단의거，두로M RA가진일보대로내혈관병변진행진단，량자연합가경전면평개ICVD병변정황，위림상진치제공삼고。
Objective To investigate the diagnostic value of neck vascular ultrasound combined with magnetic resonance angiography (MRA) in ischemic cerebrovascular disease (ICVD). Methods 92 cases of cerebral thrombosis patients (group A) ,37 cases of transient ischemic attack (TIA) patients (group B) and 50 cases of healthy persons (group C) were chosen for the study. And the neck vascular ultrasound was used for the diagnosis.Among 92 cases of thrombosis patients ,80 cases were diagnosed by MRA.The atherosclerosis incidence ,lesion characteristics and the extent of the internal carotid artery occlusion diagnosis of all the patients were compared. Results The neck vascular ultrasound showed that there was no statistically sig‐nificant difference of the plaque formation ,IMT thickness and soft plaque formation between the three groups (P> 0.05) , while compared with group C ,the difference was significant (P<0.05). There was no significant difference of the carotid ar‐tery plaque distribution of the three groups (P>0.05). The diagnosis coincidence rate of the internal carotid artery and verte‐bral artery occlusion were 87.50% and 75.00% ,respectively. The diagnostic coincidence rate of neck vascular ultrasound and MRA for mild stenosis ,moderate stenosis and severe stenosis were 92.86% ,94.12% and 85.71% ,respectively. Conclusion The neck vascular ultrasound can provide diagnostic basis for the carotid artery plaque distribution and stenosis of ICVD pa‐tients ,the MRA can further diagnose the intracranial vascular lesions. The combination of the two methods may be more com‐prehensive evaluated the ICVD disease ,and to provide reference for clinical diagnosis and treatment.