Clinical Application Of MRI Perfusion Imaging In The Auxiliary Diagnosis Of Vertebrobasilar Artery Insufficiency

Objective: Vertebrobasilar artery insufficiency(VBI)is the most common cause of central vertigo in elderly patients.They are more likely to develop into infarction,and we can consider them as the high-risk population of stroke.Although some existing examination methods can assist us in the diagnosis of VBI,it is still difficult to make a definite diagnosis of vertebral basilar artery insufficiency clinically due to the limitations of their respective examinations.MRI perfusion imaging is a relatively new and non-invasive hemodynamic detection method.By measuring the parameter of cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)and time to peak(TTP)in this study,the blood perfusion status of posterior circulation in patients with insufficient vertebral basilar artery supply was studied and observed,as well as the clinical auxiliary diagnosis of insufficient vertebral basilar artery supply,so as to facilitate the early diagnosis and treatment of the disease.Methods:Clinical data of hospitalized patients were collected and selected from April 2016 to March 2018.Elderly patients hospitalized in the Department of Geriatrics in the Second Affiliated Hospital of Nanjing Medical University with chief complaint of vertigo were selected..After admission,they received relevant biochemical examination,Transcranial Dopple(TCD),head MRI+MRA.After screening out 30 patients clinically diagnosed as vertebra basilar artery insufficiency,CBV,CBF,MTT and TTP indexes were measured.MRI cerebral blood perfusion imaging was performed on the patients respectively.Results:In the elderly patients with vertigo as the chief complaint,most of them have insufficient perfusion of the vertebrobasilar artery system,and the hypoperfusion of brain tissue in the blood supply region of the vertebrobasilar artery system can be seen in the MRI perfusion imaging.It is shown that CBV and CBF increase to different degrees or there is no obvious abnormality,and the ratio of CBV/CBF increased,while MTT and TTP were slightly prolonged.Conclusion:The CBV/CBF ratio can be changed in the early stage of vertebra basilar insufficiency,and combined with TTP index,it can be used as a sensitive indicator of early vertebra basilar insufficiency.MRI perfusion imaging can be used as a supplement to the clinical diagnosis of vertebra basilar artery insufficiency,so as to improve the early diagnosis of this disease,provide basis for the early treatment of this disease,and ultimately reduce the incidence of stroke.