Evaluation The Vascular Stenosis Of Ischemic Stroke

Objective:To compare the method of Magnetic Resonance Angiography(MRA) and Digital subtraction angiography(DSA) in assessing vessel stenosis in patients with ischemic cerebral vascular diseases and evaluate the reliability of MRA in diagnosing vascular diseases.And to find the patients suitable for the examination of DSA directly and their common clinical features.Methods:290 patients of acute ischemic stroke were examined by brain MRA or DSA from Jan,2006 to Oct,2007.Take the result of DSA as the golden standard and evaluate the reliability of MRA in diagnosing vascular diseases of patients suffered from ischemic stroke.Screening the patients with atherosclerotic vascular disease using the Toast criteria and assessing the distribution of major vascular suffered from atherosclerosis in Chinese ischemic stroke patients by the result of DSA.Results:(1)the sensitivity and specificity of MRAto diagnosis cerebral artery stenosis were 36.84%,92.32%,while positive predictive value and negative predictive value were 46.67%,88.91%.(2)During 97cases of atherosclerotic vascular diseases,38 cases(42.70%) had carotid vascular disease only,28 cases(31.46%) had intracranial vascular diseases except for carotid artery,while 23 cases(25.84%) had diseases in both place mentioned above.During 60 cases of intracranial atherosclerotic vascular diseases,2 cases(3.33%) had diseases of anterior cerebral artery,25 cases(41.67%) had diseases of middle cerebral artery,6 cases(10.00%) had diseases of posterior cerebral artery and 27 cases(45.00%) had diseases of vertebral and bathsal artery. (3) 12 cases watershed ischemic stroke were screened.7 cases had diseases of internal carotid artery whose degree of stenosis from 60% to 100%,4 cases had diseases of middle cerebral artery whose degree of stenosis from 40%to 95%.Conclusion:(1) Patients with highly suspected vascular disease clinically such as diseases in the region of middle cerebral artery and vertebral-bathsal artery,watershed ischemic stroke and posterior circulation TIA were recommended to undergo DSA directly.(2) Cerebral atherosclerotic vascular diseases in Chinese patients were mainly cause by the diseases in the region of internal carotid artery,middle cerebral artery and vertebral-bathsal artery.(3) Both the diseases of moderate internal carotid artery lesions or above and gental middle cerebral artery lesions or above can cause watershed infarctions.