高分辨磁共振血管壁成像3D CUBE T_1序列与SWI诊断颅内静脉窦血栓的对比研究

目的通过联合应用颅脑常规MRI、高分辨磁共振血管壁成像3D CUBE T_1序列及SWI对颅内静脉窦及其内血栓的显像,评价3D CUBE T_1序列和SWI对颅内静脉窦血栓(cerebral venous sinus thrombosis,CVST)的诊断效能及应用价值。方法本研究为前瞻性研究,连续纳入山东第一医科大学第一附属医院神经内科2016年3月-2017年9月临床疑诊CVST的34例患者。行颅脑MRI平扫、MRV、SWI、3D CUBE T_1序列检查。将颅脑平扫与MRV的诊断结果作为确诊CVST的参照诊断,应用ROC曲线分析评估3D CUBE T_1序列及SWI在患者及静脉窦血管节段水平诊断CVST的敏感性、特异性。结果以参照诊断为依据评判CVST的阳性患者共9例,共累计24处病变静脉窦节段。3D CUBE T_1序列在患者水平诊断CVST的敏感度和特异度分别为100%和95.2%,ROC曲线下面积为0.98;在静脉窦节段水平诊断CVST的敏感度和特异度分别为95.8%和97.7%,ROC曲线下面积为0.97。SWI在患者水平诊断CVST的敏感度和特异度分别为66.7%和76.2%,ROC曲线下面积为0.71;在静脉窦节段水平诊断CVST的敏感度和特异度分别为70.8%和95.4%,ROC曲线下面积为0.83。结论与SWI相比,高分辨磁共振血管壁成像3D CUBE T_1序列对CVST的诊断具有更高的敏感性及特异性,准确性高,能够为CVST的临床诊断及治疗提供可靠的诊断信息,具有很好的临床实用价值及应用前景。

Diagnosis Value Comparation of High-resolution MR Vessel Wall Imaging 3D CUBE T1 Weighted Sequence and SWI for Cerebral Venous Sinus Thrombosis

Objective To evaluate the diagnosis value of HR MR vessel wall imaging 3D CUBE T1 sequence
and SWI for cerebral venous sinus thrombosis (CVST).
Methods This was a prospective study. 34 consecutive suspected CVST patients from Department
of Neurology, the First Affiliated Hospital of Shandong First Medical University from March 2016
to September 2017 were included in this study. All the patients underwent MRI plain scan, MRV,
SWI and 3D CUBE T1 sequence imaging examination. The diagnostic accuracy for CVST of 3D
CUBE T1 and SWI on per patient and per venous sinus segment level were evaluated by calculating
their sensitivity, specificity, and the area under the ROC curve (AUC), with referential diagnostic
criteria of CVST diagnosis based on the combination of MRI plain scan and MRV.
Results Finally, a total of 9 CVST patients were diagnosed according to the referential criteria,including 24 venous sinus stenosis segments. For 3D CUBE T1 sequence, the sensitivity and specificity
of were 100% and 95.2% per patient, and were 95.8% and 97.7% per venous sinus segment, and AUC
was 0.98 per patient and 0.97 per venous sinus segment, respectively. For SWI, the sensitivity and
specificity were 66.7% and 76.2% per patient, and were 70.8% and 95.4% per venous sinus segment,
and AUC was 0.71 per patient and 0.83 per venous sinus segment, respectively.
Conclusions Compared with SWI, HR MRI 3D CUBE T1 sequence has a higher sensitivity and
specificity in diagnosing CVST, which can provide reliable information for diagnosis and treatment
of CVST.