目的 探讨核磁共振血管成像(MRA)联合磁共振弥散加权成像(DWI)序列对急性脑卒中动脉狭窄的诊断价值。方法 选取2015-03至2018-03入院的80例急性卒中患者为研究对象,对其MRA、DWI 以及高分辨核磁血管(HR-MRA)检查结果进行回顾性分析,以HR-MRA诊断结果为金标准,将MRA及MRA联合DWI的诊断结果进行比较。结果 MRA诊断为基底动脉狭窄的灵敏度、特异度、准确率分别为50.00%、96.87%和87.50%,MRA联合DWI检查,诊断为基底动脉狭窄的灵敏度、特异度、准确率分别为75.00%、96.87%、92.50%,后者灵敏度和准确率均高于前者。MRA诊断为大脑中动脉的灵敏度、特异度、准确率分别为63.15%、70.49%和68.75%,MRA联合DWI诊断为大脑中动脉的灵敏度、特异度、准确率分别为89.47%、86.88%、87.5%,联合诊断各项指标均高于MRA诊断。结论 相比单独MRA检查,MRA联合DWI能更准确判断动脉狭窄的部位。

Objective To assess the applicability of magnetic resonance angiography (MRA) combined with diffusion weighted imaging (DWI) in the diagnosis of arterial stenosis in acute stroke patients.Methods Eighty patients with acute stroke admitted between March 2015 and March 2018 were selected and the results of MRA, DWI and high resolution (HR-MRA) were retrospectively analyzed. The results of MRA and MRA combined with DWI were compared with those of HR-MRA.Results The sensitivity, specificity and accuracy of MRA in the diagnosis of basilar artery stenosis were 12.50%, 96.87% and 87.50%, respectively, compared to 75.00%, 96.87% and 92.50% respectively for MRA combined with DWI. The latter approach was more specific and accurate than the former. The sensitivity, specificity and accuracy of MRA in diagnosing middle cerebral artery were 63.15%, 70.49% and 68.75% respectively, while those of MRA combined with DWI in were 89.47%, 86.88% and 87.5% respectively. All indexes of diagnosis with MRA combined with DWI were higher than those of MRA alone.Conclusions MRA combined with DWI can determine the location of arterial stenosis more accurately than MRA alone.