增强与非增强MR肺动脉血管成像诊断肺栓塞准确性的对比研究

目的比较对比增强MR血管成像(contrast-enhanced MR pulmonary angiography,CE-MRA)与非增强空间标记多反转脉冲序列(applying spatial labeling with multiple inversion pulses sequence,SLEEK)MR血管成像诊断肺栓塞(pulmonary embolism,PE)的准确性。材料与方法 26例CT肺动脉血管成像诊断肺栓塞的患者(男15例,女11例)于多排螺旋CT肺动脉造影(CT pulmonary angiography,CTPA)检查48 h内行CE-MRA以及非增强SLEEK MR检查。CTPA作为参考标准,计算并比较每种MR技术诊断肺栓塞的敏感性、特异性、阳性预测值以及阴性预测值。结果 CE-MRA诊断肺栓塞的敏感性为78.8%,特异性97.7%。非增强SLEEK MRI诊断肺栓塞的敏感性83.8%,特异性100%。两阅片者间存在高度一致性(k=0.87)。结论 CE-MRA和SLEEK MRI诊断肺栓塞的准确性无统计学差异,但非增强SLEEK MRI血管成像无需使用对比剂,有希望成为肺栓塞诊断策略中的一部分。

A comparative study of contrast-enhanced and unenhanced MR pulmonary angiography in the diagnosis of pulmonary embolism

Objective: To evaluate relative detection accuracy of pulmonary embolism (PE) with contrast-enhanced MR angiography (CE-MRA) and unenhanced MR angiography by applying spatial labeling with multiple inversion pulses sequence (SLEEK) imaging.Materials and Methods: Twenty-six patients (15 males and 11 females) with computed tomographic pulmonary angiography (CTPA) diagnosed pulmonary embolism (PE) underwent contrast-enhanced MR pulmonary angiography and SLEEK MR angiography within 48 hours after CTPA. Referring to CTPA, sensitivity, specificity, and positive and negative predictive values for PE detection were calculated and compared for each MR method.Results:Sensitivities for PE detection were 78.8% for contrast-enhanced MR pulmonary angiography and 83.8%for SLEEK MR angiography respectively. Speciifcities for PE detection were 97.7% for contrast-enhanced MR Pulmonary angiography and 100% for SLEEK MR angiography respectively. Agreement between readers was relatively high (k=0.87).Conclusions:Contrast-enhanced MR pulmonary angiography and SLEEK MR angiography possessed relatively similar sensitivity and speciifcity. However, considering the non-invasive property of SLEEK MR angiography, where no contrast agent was required, it might become a potential diagnostic strategy for pulmonary embolism.