HR-MRI评估大脑中动脉粥样硬化性狭窄程度的价值探讨

目的探讨高分辨率磁共振成像(High-resolution magnetic resonance imaging,HR-MRI)诊断大脑中动脉粥样硬化性狭窄程度的价值。方法回顾性分析2009年1月至2014年2月我院门诊部收治的50例经手术病理证实的大脑中动脉粥样硬化性狭窄临床资料,患者均行HR-MRI及数据减影血管造影(Digital subtraction angiography,DSA)检查,以DSA为诊断金标准评估HR-MRI在大脑中动脉粥样硬化性狭窄程度中的诊断价值。结果 50例患者共100段大脑中动脉M1段,HR-MRI及DSA均显示未见狭窄血管、轻度狭窄血管、中度狭窄血管、重度狭窄血管及闭塞血管分别为48段、8段、18段、15段、6段;HR-MRI对大脑中动脉硬化狭窄程度与DSA诊断一致的有95段,诊断符合率为95.00%,HR-MRI诊断偏高2段,百分比为2.00%,诊断偏低3段,百分比为3.00%。结论 HR-MRI对大脑中动脉粥样硬化性狭窄程度诊断与DSA诊断方法具有较高符合率,HR-MRI在颅内血管病变狭窄程度的诊断具有一定诊断价值,值得临床推广应用。

The Assessing Value of HR-MRI in the Narrow Degree of Middle Cerebral Artery Atherosclerosis

Objective To study the assessing value of high-resolution magnetic resonance imaging (HR-MRI) in the narrow degree of middle cerebral artery atherosclerosis. Methods A retrospective analysis was performed for 50 cases with middle cerebral artery atherosclerosis, which confirmed by surgery and pathology from January 2009 to February 2009. The patients were performed MRI and DSA examination, the value of HR-MRI in the narrow degree of middle cerebral artery atherosclerosis was evaluated with the DSA results as the golden standard.Results 48, 8, 18, 15, 6 segments of no stenosis, mild stenosis, moderate stenosis, severe stenosis, vascular occlusion respectively were showed in both MR-MRI and DSA. The narrow degree of 95 segments in HR-MRI were exactly the same as DSA, the diagnostic coincidence rate was 95.00%. There were 5 cases of inaccurate assessment for higher or lower in HR-MRI, the percentage is 5.00%. Conclusion The coincidence rate of HR-MRI in the narrow degree of middle cerebral artery atherosclerosis was high compared to DSA, HR - MRI has certain diagnostic value in the diagnosis of intracranial vascular stenosis, which is worthy of clinical popularization and application.