摘要
目的探讨常规管腔成像联合磁共振管壁成像技术在头颈部动脉闭塞诊断中的价值。方法选择2016年5月至2017年5月中国人民解放军211医院收治的60例头颈部动脉闭塞病患者为研究对象,患者均行常规管腔成像和磁共振管壁成像检查,对闭塞血管局部节段的管壁特征以及远端腔内的血栓特征进行分析研究。比较常规管腔成像、常规管腔成像联合磁共振管壁成像技术诊断病因种类的准确率。结果 60例患者共诊断出闭塞血管70段,其中常规管腔成像联合磁共振管壁成像诊断出68段,准确率为97. 14%(68/70);常规管腔成像诊断出46段,准确率为65. 71%(46/70)。常规管腔成像联合磁共振管腔成像技术诊断头颈部动脉闭塞的准确率高于常规管腔成像(χ2=10. 263,P <0. 05)。常规管腔成像联合磁共振管壁成像诊断的68段动脉硬化性血管闭塞中,中动脉硬化性闭塞45段,动脉夹层性闭塞12段,动脉炎性闭塞11段。动脉硬化性闭塞患者闭塞近段的管壁均出现明显的偏心性加厚的现象,动脉夹层性闭塞患者均出现了典型的双腔征或者是新月形管壁内高信号血肿现象,动脉炎性闭塞患者闭塞血管中段出现明显的增厚和强化现象。结论常规管腔成像联合磁共振管壁成像技术,可充分显示出头颈部动脉闭塞的起始位置的动脉管壁特征,对于诊断动脉硬化性闭塞、动脉炎性闭塞以及动脉夹层性闭塞的病因具有一定的优势。
Objective To explore the diagnostic value of conventional lumen imaging combined with magnetic resonance tube wall imaging in head and neck artery occlusion. Methods Sixty patients with cephalic and carotid artery occlusive disease admitted to the 211 stHospital of Chinese People's Liberation Army from May 2016 to May 2017 were selected as subjects. All patients underwent conventional lumen imaging and magnetic resonance tube wall imaging. The wall characteristics of the local segment of occluded vessels and the characteristics of thrombus in the distal lumen were analyzed and studied. The diagnostic accuracy of conventional lumen imaging and conventional lumen imaging combined with magnetic resonance wall imaging in etiological types was compared. Results A total of 70 segments of occlusive vessels were diagnosed in 60 patients,68 segments of which were diagnosed by conventional wall imaging combined with magnetic resonance and 46 segments were diagnosed by conventional wall imaging,the accuracy of them was 97. 14%( 68/70) and 65. 71%( 46/70).The diagnostic accuracy of conventional lumen imaging combined with NMR tube wall imaging in head and neck artery occlusion was higher than that of conventional lumen imaging( χ2= 10. 263,P < 0. 05). Among the 68 segments of occlusive vessels,45 segments were middle arteriosclerosis occlusion,12 segments were dissecting arterial occlusion and 11 segments were arteritis occlusion. There was obvious eccentric thickening in the proximal segment of the occlusion of patients with atherosclerotic occlusion; there was typical double lumen sign or crescent intramural hyperintense hematoma patients with dissecting arterial occlusion of patients with arteritis occlusion; there was obvious thickening and strengthening in the middle segment of the occlusion vessel. Conclusion Conventional lumen imaging combined with magnetic resonance tube wall imaging technology is helpful to fully display the characteristics of the artery wall at the beginning of head and neck artery occlusion. It has certain advantage in the diagnosis of atherosclerotic occlusion,arteritis occlusion and dissecting arterial occlusion. It is worthy of further promotion and application.
引文
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