目的：应用磁敏感加权成像（SWI）技术研究短暂性脑缺血（TIA）脑内深部髓质静脉（DMV）的分布。方法：双盲回顾性分析118例TIA患者及32例正常志愿者的临床及脑部MR影像学资料。两位放射科医生共同判定图像质量、DMV对称性（对称定义为相同区域均有DMV显示，数量差＜5根且扩张程度相近），分别判定DMV分型并对数据进行一致性检验（Kappa）。将侧脑室旁DMV和同侧脑浅层静脉（SCV）管径对比分为3型，Ⅰ型：无DMVs；Ⅱ型：DMVs<SCVs；Ⅲ型：DMVs=SCVs。在对照组中，13例志愿者进行两型MR扫描（Siemens Verio 3.0T和GE Discover 750 3.0T）比较研究。结果：DMV分型数据一致性分析Kappa值为0.855。Man-Whitney秩和检验分析TIA组与对照组DMV分型有差异，P=0.000，P<0.05；TIA组间DMV分型无差异，P=0.633，P>0.05。对照组与TIA组DMV对称性四格表Fisher确切概率法P=0.004，P<0.05。两型MR扫描仪图像对判定DMV分型无差异（χ2=0.5，P>0.05）。结论：TIA脑内DMV判定有很好一致性，DMV可不对称分布，其管径多小于和接近脑浅层静脉。
Abstract
Objective: To investigate the distribution of deep medullary vein(DMV) in the transient ischemic attack(TIA) patients by using susceptibility-weighted imaging(SWI). Methods: MR images of 118 TIA patients and 32 healthy volunteers were double-blinded analyzed retrospectively. Two senior radiologists evaluated the image quality and DMVs symmetry at the same time, but evaluated DMV types respectively. DMVs showed identical areas in the lateral ventricles, amounts difference less than 5 and expanded similarly were defined symmetry. Kappa test were analyzed DMV types by two radiologists respectively. Contrasting superficial cerebral veins(SCV), DMV were defined in three types: type Ⅰ no visible DMVs; type Ⅱ DMVs<SCVs; type Ⅲ DMVs=SCVs. Thirteen volunteers of the control group had carried on the comparative study between two MR scanners(Siemens Verio 3.0T and GE Discover 750 3.0T). Results: The value of Kappa was 0.855 by two radiologists. By using Man-Whitney test, there was significant difference between DMV types of the TIA and the control groups(P=0.000, P
<0.05), there was also no significant difference between two groups of TIA(P=0.633, P>0.05). Fisher’s exact probabilities in 2×2 table was analyzed DMV symmetry of two groups(TIA and the health)(P=0.04, P<0.05). There was no difference in determining the DMV types between two MR scanners(χ2=0.5, P>0.05). Conclusions: DMV judgement of TIA patients had good consistency. DMV in the TIA could be asymmetric distribution and its diameter was much smaller than or close to SCV.
关键词
脑缺血发作 /
短暂性 /
磁共振成像
Key words
Ischemic attack, transient /
Magnetic resonance imaging
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基金
辽宁省自然科学基金计划项目（201602768）
