MR二维时间飞跃法、三维梯度毁损回波序列及时间分辨对比剂动态显像诊断颅内静脉窦血栓

目的 观察MR二维时间飞跃法(2D-TOF)、三维梯度毁损回波序列(3D-SPGR)及时间分辨对比剂动态显像(TRICKS)诊断颅内静脉窦血栓(CVST)的价值。方法 前瞻性纳入38例疑诊脑静脉血栓患者，对其行MR 2D-TOF、3D-SPGR、TRIKS及数字减影血管造影(DSA)检查；以DSA为金标准，观察3种MR序列显示颅内静脉窦的能力，评估其诊断CVST的效能。结果 38例中，9例MRI及DSA均诊断CVST、29例MRI及DSA均提示无CVST。3D-SPGR及TRICK序列图像均可显示上矢状窦、下矢状窦、双侧横窦、双侧乙状窦、直窦及窦汇，且二者对上矢状窦、双侧横窦及左侧乙状窦的显示率均明显高于2D-TOF(P均<0.05)。2D-TOF诊断CVST的效能低于DSA(P=0.025),而3D-SPGR及TRICKS诊断CVST的效能与DSA无明显差异(P=0.34、0.26);2D-TOF、3D-SPRG和TRICKS诊断CVST与DSA的一致性分别为中等、极高和高(Kappa=0.570、0.917、0.788),其诊断CVST的曲线下面积分别为0.716、0.910...

MR two-dimensional time-of-flight, three-dimensional spoil gradient recall and time-resolved imaging of contrast kinetics for diagnosing cerebral venous sinus thrombosis

Objective To explore the value of MR two-dimensional time-of-flight (2D-TOF), three-dimensional spoil gradient recall (3D-SPGR) and time-resolved imaging of contrast kinetics (TRICKS) for diagnosing cerebral venous sinus thrombosis (CVST). Methods Totally 38 patients with suspected cerebral venous thrombosis were prospectively enrolled. MR 2D-TOF, 3D-SPGR, TRICKS and digital subtraction angiography (DSA) were performed. Taken DSA as golden standard, the abilities of 3 MR sequences for displaying intracranial venous sinuses were observed, and the efficacies of 3 MR sequences for diagnosing CVST were evaluated. Results Among 38 patients, with both MRI and DSA, 9 patients were found with CVST, while 29 cases were found without CVST. The superior sagittal sinus, inferior sagittal sinus, bilateral transverse sinus, bilateral sigmoid sinus, straight sinus and sinus confluence could be observed on 3D-SPGR and TRICKS sequence images, and the display rates of superior sagittal sinus, bilateral transverse sinus and left sigmoid sinus on 3D-SPGR and TRICKS sequence images were all significantly higher than that on 2D-TOF images (all P<0.05). The efficacy of 2D-TOF for diagnosing CVST was lower than that of DSA (P=0.025), while no significant difference of efficacy for diagnosing CVST was found between 3D-SPGR and DSA (P=0.34), nor between TRICKS and DSA (P=0.26). The consistency of 2D-TOF, 3D-SPRG and TRICKS with DSA for diagnosing CVST was moderate, extremely high and high, respectively (Kappa=0.570, 0.917, 0.788), and the area under the curve of 2D-TOF, 3D-SPGR and TRICKS for diagnosing CVST was 0.716, 0.910 and 0.841, respectively. Conclusion The efficacy of 3D-SPGR for diagnosing CVST was comparable to DSA and superior to that of 2D-TOF and TRICKS.