本文選題：高分辨核磁共振成像 + TOAST分型�。� 參考：《石河子大學(xué)》2017年碩士論文

【摘要】：目的利用高分辨核磁成像對(duì)顱內(nèi)動(dòng)脈血管病變情況進(jìn)行分析,包括斑塊(分布、重構(gòu)、出血)、血管狹窄(部位、程度及有無閉塞)等影像學(xué)特點(diǎn)的檢測(cè)結(jié)果;評(píng)價(jià)高分辨核磁在腦梗死TOAST分型中的應(yīng)用價(jià)值。方法選取石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院神經(jīng)內(nèi)科收治的經(jīng)CT/MRI確診為急性腦梗死的患者60例,入院后收集患者的一般資料,依據(jù)實(shí)驗(yàn)室相關(guān)檢查、頸動(dòng)脈超聲、動(dòng)態(tài)心電圖、動(dòng)態(tài)血壓及患者的既往病史、癥狀、體征行初步的TOAST分型,此后行高分辨核磁共振成像(T1WI、T2WI、PDWI、FLAIR、CUBE-T1序列)檢查,評(píng)價(jià)顱內(nèi)動(dòng)脈血管及頸動(dòng)脈血管內(nèi)膜有無增厚、狹窄、斑塊、斑塊的性質(zhì)、斑塊的分布及斑塊有無重構(gòu)及出血等,經(jīng)影像科專家讀片、審核、作出診斷報(bào)告后,再次行TOAST分型,分析腦梗死患者五種分型的一般資料、一般普通檢查與高分辨核磁共振成像所占百分比的比較,評(píng)估高分辨核磁共振成像對(duì)腦梗死分型的意義。結(jié)果(1)60例患者行一般檢查前,一般資料的比較中,高血壓、糖尿病、冠心病等在大動(dòng)脈粥樣硬化型、小動(dòng)脈閉塞型腦梗死中所占比例偏高;五組患者的低密度脂蛋白、同型半胱氨酸、胱抑素C等比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);(2)顱內(nèi)外血管的高分辨核磁共振檢查發(fā)現(xiàn):雙側(cè)顱內(nèi)動(dòng)脈以大腦前、中、后的動(dòng)脈粥樣硬化為主,顱外動(dòng)脈的粥樣硬化、斑塊、狹窄表現(xiàn)也集中在大動(dòng)脈粥樣硬化組、小動(dòng)脈閉塞組;(3)行一般普通檢查與高分辨核磁五組分型所占的百分比差異無意義(P0.05);大動(dòng)脈粥樣硬化型、小動(dòng)脈閉塞型所占的比例有所上升,而不明原因患者所占的比例下降了5%,心源性栓塞型、已知原因型患者所占的比例無變化。結(jié)論1高分辨核磁成像對(duì)顱內(nèi)外血管病變具有較高的識(shí)別度。2高分辨核磁對(duì)缺血性腦血管病的病因、診斷、分型具有重要意義,為腦梗死事件的診治、二級(jí)預(yù)防提供重要參考依據(jù),值得臨床推廣。
[Abstract]:Objective to analyze the vascular lesions of intracranial arteries by high-resolution magnetic resonance imaging (HRNMR), including the findings of plaque (distribution, remodeling, hemorrhage), stenosis (location, degree and occlusion), and so on. To evaluate the value of high resolution magnetic resonance (HRNMR) in the classification of TOAST in cerebral infarction. Methods Sixty patients with acute cerebral infarction diagnosed by CT / MRI were selected from the Department of Neurology, the first affiliated Hospital of Shihezi University Medical College. The general data of the patients were collected after admission. The data were collected according to the relevant laboratory examination, carotid ultrasound and dynamic electrocardiogram. Ambulatory blood pressure (ABBP) and previous history, symptoms and signs of the patients were classified by toast, and then high-resolution magnetic resonance imaging (T1WII-T2WIP) was performed to evaluate the thickening, stenosis and plaque of intracranial artery and carotid artery intima. The character of plaque, the distribution of plaque, whether there were remodeling and bleeding, etc. After the image expert read, examined and made the diagnosis report, the TOAST classification was performed again, and the general data of the five types of cerebral infarction patients were analyzed. To evaluate the significance of high resolution magnetic resonance imaging (HRMRI) in the classification of cerebral infarction by comparing the percentage of conventional MRI and high resolution MRI. Results (1) the proportion of hypertension, diabetes and coronary heart disease in cerebral infarction of arteriosclerosis type and arteriole occlusion type was higher than that of general data before general examination in 60 patients, the low density lipoprotein (LDL) of the five groups was low density lipoprotein (LDL), low density lipoprotein (LDL) in the five groups, The differences of homocysteine and cystatin C were statistically significant (P0.05); (2). The results of high resolution magnetic resonance imaging showed that bilateral intracranial arteries were mainly atherosclerosis in anterior, middle and posterior cerebral arteries, and atherosclerosis in extracranial arteries. Plaque, stenosis also concentrated in the arteriosclerosis group, arteriole occlusion group; (3) the general examination and high-resolution nuclear magnetic resonance five groups of the percentage difference is not significant (P0.05); large artery atherosclerosis type, The proportion of arteriole occlusion type increased, while the proportion of unknown cause patients decreased by 5%, cardiogenic embolism type, the proportion of known cause type patients did not change. Conclusion (1) High resolution nuclear magnetic resonance imaging has a high degree of recognition for intracranial and extracranial vascular lesions. 2 High resolution nuclear magnetic resonance imaging is of great significance in the etiology, diagnosis and classification of ischemic cerebrovascular diseases, and is of great significance in the diagnosis and treatment of cerebral infarction events. The two-level prevention provides important reference basis and is worth popularizing in clinic.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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