大脑中动脉粥样硬化狭窄的3.0T HR-MRI和DSA比较研究

黄俊; 郭富强; 陈士跃; 刘崎

中国临床医学影像杂志 ›› 2014, Vol. 25 ›› Issue (8) : 551-554.

论著

大脑中动脉粥样硬化狭窄的3.0T HR-MRI和DSA比较研究

黄俊1，郭富强1，陈士跃2，刘崎2

作者信息 +

Comparison of 3.0T high-resolution MRI and DSA of middle cerebral artery atherosclerotic stenosis

HUANG Jun1, GUO Fu-qiang1, CHEN Shi-yue2, LIU Qi2

Author information +

文章历史 +

摘要

目的：对比分析3.0T HR-MRI和DSA对疾病患者的大脑中动脉M1段（即水平段）狭窄程度的诊断符合情况，探讨3.0T HR-MRI评价大脑中动脉狭窄程度的临床价值。方法：67例大脑中动脉狭窄患者均行3.0T HR-MRI和DSA检查，并以DSA为金标准计算HR-MRI诊断大脑中动脉狭窄程度的敏感性、特异性、准确性以及阳性预测值、阴性预测值，分析3.0T HR-MRI诊断大脑中动脉狭窄程度与DSA的符合情况。结果：67例病人共134段目标血管，HR-MRI与DSA诊断相符合共124段，符合率92.5%，HR-MRI诊断大脑中动脉轻、中、重度狭窄及闭塞的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为80%、99.2%、98.5%、80%、99.2%，95.7%、98.5%、91.4%、84.6%、98.5%，84%、98.2%、91.4%、80.8%、95.7%，100%、100%、100%、100%、100%。Youden指数分别为79.2%、94.2%、82.2%、100%，Kappa值分别为0.792、0.788、0.895、1。结论：3.0T HR-MRI在评价大脑中动脉狭窄程度方面具有很高的敏感性、特异性和准确性，与DSA诊断有很好的相关性，结合管壁成像，可作为大脑中动脉粥样硬化狭窄筛查的一种常规检查方法。

Abstract

Objective: To compare 3.0T HR-MRI and DSA for the diagnosis of the middle cerebral artery M1 segment stenosis and discuss the clinical value and limitation of 3.0T HR-MRI in the diagnosis of middle cerebral artery atherosclerotic stenosis. Methods: Sixty-seven patients with ischemic cerebrovascular disease received both 3.0T HR-MRI and DSA examinatin. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of 3.0T HR-MRI diagnosis of middle cerebral artery stenosis were calculated using DSA as the golden standard. The clinical value of 3.0T HR-MRI diagnosis of intracranial vascular stenosis was evaluated． Results: Among 67 patients, 124 blood vessels showed the same condition as DSA, with the coincidence rate of 92.5%. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value in 3.0T HR-MRI diagnosis of mild degree, moderate degree, severe degree stenosis and obliteration were 80%, 99.2%, 98.5%, 80%, 99.2%; 95.7%, 98.5%, 91.4%, 84.6%, 98.5%; 84%, 98.2%, 91.4%, 80.8%, 95.7%; 100%, 100%, 100%, 100%, 100%． For mild, moderate, severe degree stenosis, and occlusion of MCA rates according to Youden index were 79.2%, 94.2%, 82.2%, 100%; Kappa values were 0.792, 0.788, 0.895, 1． Conclusions: 3.0T HR-MRI evaluation of middle cerebral artery atherosclerotic stenosis has a high sensitivity, specificity and accuracy, with a good relevance with DSA. 3.0T HR-MRI can replace DSA to become a general choice for cerebrovascular stenosis screening examination．

导出引用

黄俊;郭富强;陈士跃;刘崎. 大脑中动脉粥样硬化狭窄的3.0T HR-MRI和DSA比较研究[J]. 中国临床医学影像杂志. 2014, 25(8): 551-554

HUANG Jun;GUO Fu-qiang;CHEN Shi-yue;LIU Qi. Comparison of 3.0T high-resolution MRI and DSA of middle cerebral artery atherosclerotic stenosis[J]. Journal of China Clinic Medical Imaging. 2014, 25(8): 551-554

中图分类号： Ｒ743.1 Ｒ445.2 Ｒ814.43