A Clinical Comparative And Correlative Study Of MRI MRA TCD And Arteria Carotis Cypersound In Acute Ischemic Stroke

Objective:To get more diagnostic and therapeutic information from the acute cerebral infarct,we used Magnetic resonance imaging,Arteria carotis hypersound,Magneticresonancean giography,Transcranial Dopplerand and Computed Tomography to investigate the changes and relationship of cerebrovascular,cerebral hemodynamics,morphological changes and the clinical neurologic deficit.Methods:Fifty patients with a first acute ischemic stroke involving hemispheric middle cerebral artery(MCA) territory after onset were studied.These patients were subsequently underwent Computed tomography,Magnetic resonance imaging and Magnetic resonance angiography,Transcranial Doppler,Arteria carotis hypersound after admittion.Giving the data we got comparing analysis and relative analysis.Results:After admittion,TCD abnormal rate was higher than CT,mean velocity of middle cerebral artery(V_m MCA)of the lesion-side was lower than the contra side and the control group,and significant difference of the mean velocity of middle cerebral artery of the lesion-side was noted when compared with the contra side and the control group(P＜0.05).On conventional MRI,infarction showed that 15cases presented to equal T₁ and long T₂ signal intensity uniformly slightly,whose boundary was not clear;35 cases presented to long T₂ and long T₂ signal intensity uniformly slightly,whose boundary was blurred,conventional MRI abnormal rate was 100%.30 patients with acute cerebral infarction showed high signal intensity in DWI and DWI abnormal rate was 100%.Results of MRA demonstrated left Middle Cerebral Artery occlusion in 12 cases and right in 13 cases;cerebral arteriosclerosis in 8 cases;cerebral artery innate dysplasia in 3 cases,and normal in 14 cases.No significant difference between TCD and MRA was noted normal in 14 cases.Through CDFI of carotid ultrasound,it shows that there are 4 case in the changes of typeâ… ,32 cases in the changes of typeâ…¡,5 cases in the changes of typeâ…¢,4 cases Changes of typeâ…£and normal 4 cases. Which,in the Changes of typeâ…¡,there are flat spot or morphea with 29 cases, soft spot with 27 cases and ulcerative plaque with 21 cases.Conclusions:(1)Mean velocity of middle cerebral artery(V_m MCA)of the lesion-side was lower in acute ischemic stroke and no significant difference was noted between TCD and MRA in the examination of cerebral artery,Combined the both,the change of cerebrovascular can be well comprehended.(2)when the middle cerebral artery obstruction or occlusion,it could provide the indirect hemodynamics basis for clinical through TCD,and it could provide the direct morphology standards for clinical through MRA.Combination of the two,it could be a better understanding of changes in cerebral vascular.(3)It is limited in diagnose stenosis or occlusion with middle cerebral artery through the CDFI of carotid ultrasound.But,it could provide the indirect basis for clinical.(4)It plays good complementary role through the carotid artery ultrasonography and Transcranial Doppler in the diagnosis of carotid artery atherosclerosis.