症状性颅、颈部动脉狭窄在3.0T上的MRA与DSA比较研究

目的前瞻性分析3．0T应用SENSE技术的高分辨率对比增强容积扫描MRA（CEMRA）和3DTOFMRA在临床疑有颅、颈部动脉狭窄性病变患者中的应用价值。方法46例临床怀疑颅、颈部动脉狭窄的患者接受头颅MRI平扫、头颅3DTOFMRA和颈部CEMRA检查。动脉狭窄的程度与DSA检查结果进行相关性比较。结果MRA显示各段颅、颈部动脉狭窄的不同程度和DSA检查显著相关（Rs=0．97，P〈0．01）。以DSA结果为金标准，狭窄程度超过50％者MRA诊断灵敏度为100％，特异度为99．4％、准确率为99．4％。结论3．0T的3DTOFMRA和高分辨率CEMRA检查能可靠和有效地评价颅、颈部动脉狭窄性病变，可作为DSA术前必要的检查技术，或可替代传统DSA诊断性检查。

Evaluation of 3.0 Tesla MRA in diagnosing symptomatic craniocervicai artery stenosis: a comparative study with DSA

Objective To prospectively evaluate 3D time-of-flight magnetic resonance angiography (3DTOF MRA) and high resolution contrast enhanced volume scan magnetic resonance angiography (CEMRA) with sensitivity encoding in diagnosing craniocervical artery stenosis. Methods Forty-six patients suspected with craniocervical artery diseases underwent MRI, 3DTOF MRA of the head and also CEMRA of the neck. The images of MRA were reconstructed with MIP and VR. The degree of arterial stenosis demonstrated on MRA was compared with that showed on digital subtraction angiography(DSA), and the data were analyzed with Spearman rank correlation coefficient (Rs). Results Excellent correlation in determining the degree of craniocervical artery stenosis existed between MRA and DSA (Rs = 0.97). With DSA as a golden standard, the sensitivity, specificity and accuracy of MRA in detecting over 50% arterial stenosis were 100%, 99.4% and 99.4% respectively. Conclusion 3DTOF MRA and CEMRA with sensitivity encoding at 3.0T are reliable and effective examinations for evaluating craniocervical artery disease. These techniques can be used as the necessary exams before DSA and can even substitute for the conventional DSA in some instances.