三维磁共振管壁成像与数字减影血管造影诊断颈动脉闭塞的对照研究

目的通过与数字减影血管造影(DSA)比较,评价三维磁共振管壁成像(3D-MR-VWI)技术诊断颈动脉闭塞形态学特征的可行性。资料与方法纳入经超声诊断为颅外段颈动脉闭塞(CAO),并于1周内完成3D-MR-VWI和DSA检查的124例患者。评价3D-MR-VWI与DSA在诊断CAO类型和闭塞发生部位的一致性。结果3D-MR-VWI对于颈动脉完全闭塞及闭塞起始部位的诊断与DSA结果均有较高的一致性(Cohen’s κ=0.85,95%CI 0.71~0.94;Cohen’s κ=0.85,95%CI 0.71~0.97)。3DMR-VWI诊断颈动脉完全闭塞的敏感度为97.0%,特异度为86.7%,准确率为94.6%。结论3D-MR-VWI能够准确诊断CAO并判定闭塞的形态学特征,可为临床诊治颈动脉闭塞性病变提供参考。

Three-Dimensional Magnetic Resonance Vessel Wall Imaging and Digital Subtraction Angiography in the Diagnosis of Carotid Artery Occlusion:a Comparative Study

Purpose To evaluate the feasibility of three-dimensional magnetic resonance vessel wall imaging(3D-MR-VWI)in the diagnosis of carotid artery occlusion by comparison with digital subtraction angiography(DSA).Materials and Methods 124 patients diagnosed as extracranial carotid artery occlusion(CAO)by ultrasound,and completed 3D-MR-VWI and DSA within 1 week were enrolled in this study.The consistency of 3D-MR-VWI and DSA in the diagnosis of CAO type and the location of occlusion was analyzed.Results The diagnosis of complete carotid occlusion and initial site of occlusion by 3D-MR-VWI was highly consistent with DSA results(Cohen's κ=0.85,95%CI 0.71-0.94;Cohen's κ=0.85,95%CI 0.71-0.97).The sensitivity,specificity and accuracy rate of 3D-MR-VWI in the diagnosis of carotid artery occlusion was 97.0%,86.7%and 94.6%,respectively.Conclusion 3D-MR-VWI can accurately diagnose CAO and determine the morphological characteristics of occlusion,and can provide a reference for clinical diagnosis and treatment of carotid occlusive disease.