3.0T高分辨率CE-MRA对颈部血管狭窄的诊断价值

目的探讨三维对比增强磁共振血管成像(3D CE-MRA)在颈部动脉血管狭窄诊断中的临床应用价值。方法对23例临床拟诊颈部动脉血管狭窄行数字减影血管造影(DSA)的患者行颈部3D CE-MRA。将两种方法检查结果进行相关性比较。结果 23例患者共230个节段血管,3D CE-MRA显示了227个节段,共诊断出74处(32.6%)狭窄,其中28处轻度狭窄,22处中度狭窄,20处重度狭窄,4处闭塞;DSA共显示了230个节段的血管,共诊断出69处(30.4%)血管狭窄,其中24处轻度狭窄,23处中度狭窄,19处重度狭窄,3处闭塞。与DSA相比,3DCE-MRA对颈部动脉轻度、中度、重度狭窄及动脉闭塞的显示敏感性均为100%,特异性分别为85.71%、90.91%、90%和75%,两种检查方法对颈部动脉狭窄程度的判断有良好的一致性(κ=0.921,P=0.000)。结论 3.0T 3DCE-MRA能够可靠的评价颈部动脉狭窄性病变,基本可以替代DSA检查。

Diagnostic performance of 3.0 T High Resolution Contrast Enhanced Magnetic Resonance Angiography in Carotid Stenosis: Comparative Analysis with DSA

Objective To analyze the diagnostic value of 3D contrast enhanced MR angiography(3D CE-MRA) in carotid stenosis.Methods Twenty-three patients with suspected carotid stenosis underwent 3D CE-MRA followed by digital subtraction angiography(DSA).The degree of arterial stenosis demonstrated on 3D CE MRA was compared with on the results of DSA.Results Overall,230 segments of carotid arteries in 23 patients were analyzed.227 segments of corotid arteries were distinctly displayed on 3D CE MRA.The number of segments with mild stenosis,moderate stenosis,severe stenosis and vessel occlusion was 28,22,20 and 4,respectively.DSA showed all 230 segments of arteries with high quality.The number of segments with mild stenosis,moderate stenosis,severe stenosis and vessel occlusion was 24,23,19 and 3 on DSA.According to DSA results,the sensitivity of diagnosing mild,moderate,severe stenosis and occlusion were 100%,and the specificity was 85.71%,90.91%,90% and 75%,respectively.3D CE-MRA showed high consistency with DSA in evaluating carotid stenosis(κ=0.921,P=0.000).Conclusion 3D CE-MRA may display carotid stenosis accurately.This new reliable technique has potential to take the place of DSA.