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目的探讨利用PWI联合MRA技术评价椎基底动脉狭窄所致后循环远端的无症状型缺血情况。方法设立3组研究对象。A组:无症状组(n=22);B组:症状组(n=22);C组:健康对照组(n=30)。分析3组PWI和MRA检查资料,观察后循环血管狭窄程度,侧支血管分级的显示,局部脑血流量(r CBF)、局部脑血容量(r CBV)、平均通过时间(r MTT)指标。结果 3组研究对象前后循环血管的MRA图像均取得满意效果;A、B、C 3组后交通动脉开放的比率分别为68.2%(15/22)、77.3%(17/22)、50%(15/30),软脑膜动脉生成的比率分别为31.8%(7/22)、59.1%(13/22)、23.3%(7/30);A组与C组比较,r CBF、MTT存在差异,r BCV无明显差异;A组与B比较,B组的r CBF、r BCV下降,MTT延长,存在统计学差异。结论 PWI联合MRA,能够评价无症状型后循环缺血的范围及侧支循环血流,可以尽早地为临床提示后循环血液动力学状况,为治疗及评价预后提供帮助。
Objective To investigate the use of PWI combined with MRA in the evaluation of vertebrobasilar artery stenosis after the distal asymptomatic ischemic situation. Methods Three groups of subjects were set up. Group A: asymptomatic group (n = 22); Group B: symptom group (n = 22); Group C: healthy control group (n = 30). The data of PWI and MRA in 3 groups were analyzed. The degree of posterior circulation stenosis, collateral vessel grade, r CBF, r CBV and r MTT were observed. Results The MRA images of the circulating blood vessels in the three groups of patients achieved satisfactory results. The rates of posterior communicating artery opening in groups A, B and C were 68.2% (15/22), 77.3% (17/22), 50% 15/30), and the rates of pial arteries were 31.8% (7/22), 59.1% (13/22) and 23.3% (7/30) respectively. There was a significant difference in r CBF and MTT between group A and group C , r BCV no significant difference; A group and B compared to B group r CBF, r BCV decreased MTT prolongation, there is a statistically significant difference. Conclusions PWI combined with MRA can evaluate the scope of asymptomatic posterior circulation ischemia and collateral circulation blood flow, which can help to improve the hemodynamic status after the clinical presentation and to treat and evaluate the prognosis.