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目的 :选取了老年糖尿病合并脑梗死患者进行头部MRI及MRA检查,以期对MRI及MRA两种检测方法进行初步评估。方法 :采用回顾性分析,本院2013年3月~2014年12月收治的经最终确诊为老年糖尿病合并脑梗死患者260例,同时误诊为老年糖尿病合并脑梗死患者30例为研究对象。所有研究对象均采用过MRI和MRA两种方法进行诊断。结果 :MRA异常率在糖尿病病程0.5~5年,6~10年,11~15年均高于MRI异常率,其中0.5~5年,11~15年时差异有统计学意义。随着病程逐渐延长,16~22年时,MRA异常率与MRI异常率趋于一致。260例老年糖尿病合并脑梗死最终检查出215例,漏诊45例,误诊6例,筛查出非老年糖尿病合并脑梗死24例,灵敏度为82.7%,特异度为80%,符合率为82.4%。260例老年糖尿病合并脑梗死最终检查出242例,漏诊18例,误诊3例,筛查出非老年糖尿病合并脑梗死27例,灵敏度为93.1%,特异度为90%,符合率为92.8%。两种方法的灵敏度、符合率的比较均存在统计学差异,MRA组显著高于MRI组。特异度不存在统计学差异。结论 :在诊断老年糖尿病合并脑梗死患者中MRA具有一定的优势,MRI和MRA结合可同时检出脑实质梗死灶,并能够同时了解病变血管,是选择治疗方案的重要依据。
OBJECTIVE: To select MRI and MRA for the elderly patients with diabetes mellitus complicated with cerebral infarction in order to evaluate the MRI and MRA methods. Methods: A retrospective analysis of our hospital from March 2013 to December 2014 admitted to the final diagnosis of elderly patients with diabetes mellitus cerebral infarction in 260 cases, misdiagnosed as 30 cases of elderly patients with diabetes mellitus and cerebral infarction as the research object. All subjects were diagnosed by both MRI and MRA methods. Results: The abnormal rate of MRA in the course of diabetes was 0.5-5 years, 6-10 years and 11-15 years, all higher than the MRI abnormality rate, of which 0.5-5 years and 11-15 years showed statistically significant differences. With the gradual extension of the course of disease, 16 to 22 years, MRA abnormality rate and MRI abnormalities tend to be consistent. Of the 260 elderly patients with cerebral infarction with diabetes mellitus, 215 cases were missed, 45 cases were misdiagnosed and 6 cases were misdiagnosed. 24 cases of non-elderly diabetes mellitus complicated with cerebral infarction were screened. The sensitivity and specificity were 82.7% and 80% respectively. The coincidence rate was 82.4%. 260 cases of senile diabetes mellitus complicated with cerebral infarction were detected in 242 cases, 18 cases missed diagnosis and 3 cases misdiagnosed. Among 27 cases of non-elderly diabetes mellitus complicated with cerebral infarction, 27 cases were detected with sensitivity of 93.1%, specificity of 90% and coincidence rate of 92.8%. Sensitivity and coincidence rate of the two methods were statistically significant differences, MRA group was significantly higher than the MRI group. There was no statistical difference in specificity. Conclusion: MRA has certain advantages in the diagnosis of elderly patients with diabetes mellitus complicated with cerebral infarction. MRI combined with MRA can detect cerebral parenchymal infarction at the same time and can understand the diseased vessels at the same time. It is an important basis for selecting the treatment plan.