对比PETRA-MRA、TOF-MRA及CTA评估颅脑前循环动脉狭窄

目的 对比径向采集逐点编码缩短时间MR血管成像（PETRA-MRA）、时间飞跃法MRA （TOF-MRA）及CT血管成像（CTA）评估颅脑前循环动脉狭窄程度及长度的效能。方法 回顾性分析56例经颅脑数字减影血管造影（DSA）确诊颅脑前循环动脉狭窄患者的颅脑PETRA-MRA、TOF-MRA和CTA资料，采用组内相关系数（ICC）及Bland-Altman法观察PETRA-MRA与TOF-MRA、CTA评估颅脑前循环动脉狭窄程度及长度与DSA结果的一致性，以及分析上述评估结果与DSA的相关性。结果 Bland-Altman分析显示，以DSA为标准，PETRA-MRA评估颅脑前循环动脉狭窄程度的变异系数、偏差及一致性限度范围分别为13.30%、1.04及（－13.37，15.46），TOF-MRA分别为15.89%、2.81及（－14.68，20.29），CTA分别为20.17%、11.19及（－12.66，35.04）。PETRA-MRA、TOF-MRA及CTA评估颅脑前循环动脉狭窄程度（ICC=0.92、0.89、0.80），以及PETRA-MRA、TOF-MRA评估颅脑前循环动脉狭窄长度与DSA结果的一致性均好（ICC=0.99、0.97），而CTA评估颅脑前循环动脉狭窄长度与DSA结果的一致性差（ICC=0.30）。PETRA-MRA、TOF-MRA及CTA评估颅脑前循环动脉狭窄程度（r_s=0.94、0.86、0.80）及其长度（r_s=0.98、0.97、0.70）均与DSA结果呈正相关（P均<0.01）。结论 PETRA-MRA评估颅脑前循环动脉狭窄的效能优于TOF-MRA及CTA。

Comparison of PETRA-MRA, TOF-MRA and CTA for evaluating stenosis of intracranial anterior circulation arteries

Objective To compare the efficacies of pointwise encoding time reduction with radial acquisition MR angiography (PETRA-MRA), time of flight MRA (TOF-MRA) and CT angiography (CTA) for assessing the degree and length of stenosis of intracranial anterior circulation arteries. Methods Data of cranial PETRA-MRA, TOF-MRA and CTA of 56 patients with stenosis of intracranial anterior circulation arteries confirmed by digital subtraction angiography (DSA) were retrospectively analyzed. Intra-class correlation coefficient (ICC) and Bland-Altman plots were used to explore the consistencies of PETRA-MRA, TOF-MRA and CTA with DSA for assessing the degree and length of stenosis of intracranial anterior circulation artery, and the correlations with DSA results were analyzed. Results Bland-Altman plots showed that taken DSA results as the gold standard, the coefficient of variation, Bias and limits of agreement of PETRA-MRA for evaluation on the degree of anterior cerebral circulation artery stenosis was 13.30%, 1.04 and (-13.37, 15.46), respectively, of TOF-MRA was 15.89%, 2.81 and (-14.68, 20.29), while of CTA was 20.17%, 11.19 and (-12.66, 35.04), respectively. The degree of stenosis of anterior cerebral circulation artery assessed with PETRA-MRA, TOF-MRA and CTA were in good agreement (ICC=0.92, 0.89, 0.80) with DSA results, so were the length of stenosis assessed with PETRA-MRA, TOF-MRA (ICC=0.99, 0.97), but the length of stenosis assessed with CTA was in bad agreement (ICC=0.30) with DSA results. The degree (r_s=0.94, 0.86, 0.80) and length (r_s=0.98, 0.97, 0.70) of stenosis of anterior cerebral circulation artery assessed with PETRA-MRA, TOF-MRA and CTA were all positively correlated with DSA results (all P<0.01). Conclusion The efficacy of PETRA-MRA was higher than that of TOF-MRA and CTA for assessing stenosis of intracranial anterior circulation artery.