3.0T时间飞跃法MRA诊断颅内动脉瘤-与DSA对照

目的评价3.0T时间飞跃法磁共振血管成像(3.0TTOFMRA)对颅内动脉瘤的诊断价值。方法对34例临床提示颅内动脉瘤患者前瞻性行3.0TTOFMRA及脑血管DSA检查。所有图像由3名医师分成2组在工作站上进行读片。第1组由2名高年资神经影像组医师分别独立阅读重建的最大密度投影(MIP)图像;第2组由1名高年资神经影像组医师同时阅读MIP和原始数据图像(sourceimage)。以DSA诊断结果作为标准,评价3.0TTOFMRA诊断颅内动脉瘤的灵敏度、特异度及正确率。结果DSA共检测20枚动脉瘤(19例),其中颈内动脉7例,前交通动脉5例,后交通动脉5例,大脑前、中动脉各1例。TOFMRA总体诊断灵敏度、特异度、正确率分别为94.8%、89.4%和91.4%。第2组的诊断有效性最高,两组间诊断阳性率差异无统计学意义(χ2=0.242,P>0.05和χ2=0.172,P>0.05)。结论3.0TTOFMRA作为一种快速、无创的影像检查方法,能够很好显示颅内动脉瘤。MIP结合Source图像可提高3.0TTOFMRA诊断的准确性。

Detection of intracranial aneurysm with time-of-flight MRA at 3.0Tesla:comparison with digital subtraction angiography

Objective To evaluate the diagnostic accuracy of time-of-flight (TOF)MRA with 3.0 Tesla scanner for intracranial aneurysms. Methods Thirty four patients clinically suspected intracranial aneurysm underwent both 3.0T TOF MRA and intra-arterial digital subtract angiography (DSA)examination. All image data were prospectively interpreted by three experienced neuroradiologists on post-processed workstation. Two of them retrospectively read the MIP images alone, as group I; one of them read both the MIP and source images, as group II. Considering the results of DSA as the standard reference, we evaluated the sensitivity, specificity, and accuracy of 3.0T TOF MRA for imaging the intracranial aneurysms. Results Twenty aneurysms (19 cases) were detected on DSA examinations, including internal carotid artery (7), anterior communicating artery (5), posterior communicating artery (5), anterior cerebral artery(1)and middle cerebral arter(1). The overall sensitivity, specificity and accuracy of MRA were 94.8%, 89.4%, and 91.4% respectively. The diagnostic performance efficacy in group II was higher than group I, but no statistically significant difference between group I and group II was found on the diagnostic accuracy of 3.0T TOF MRA. Conclusion 3.0T TOF MRA is a rapid, non-invasive diagnostic imaging method and can clearly display the contour of the intracranial aneurysms. MIP combined with Source images could improve the diagnostic accuracy of 3.0T TOF MRA for detection of intracranial aneurysms.