高分辨磁共振管壁成像技术在颅内动脉瘤破裂风险评估中的可行性
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摘要
目的探讨分析高分辨磁共振(HR-MRI)管壁成像技术在颅内动脉瘤破裂风险评估中的可行性。方法将该院60例经三维数字减影血管造影(DSA)技术诊断为颅内动脉瘤破裂患者分为瘤壁强化组(24例)和瘤壁未强化组(36例),所有研究对象在术前行HR-MRI管壁成像检查,观察瘤壁强化与颅内动脉瘤破裂的关系,进而探究HR-MRI成像技术在颅内动脉瘤破裂风险评估中的可行性。结果所有研究对象HR-MRI管壁成像检查显示颅内动脉瘤破裂的有41例,准确率为68.33%;瘤壁未强化组中瘤体破裂的比例(9.80%)明显低于瘤壁强化组(18.42%),差异有统计学意义(χ~2=1.39,P<0.05);2组患者中有子囊与无子囊患者例数,SR<2与SR≥2患者例数比较,差异均有统计学意义(χ~2=5.62、9.26,P<0.05)。结论 HR-MRI成像技术对颅内动脉瘤破裂有少许的漏诊率,但成像结果显示瘤体破裂的风险与瘤壁强化有明显关系,影响瘤壁强化的因素包括瘤体有无子囊及瘤体体率等动脉瘤形态学特征。
Objective To investigate the feasibility of high resolution magnetic resonance imaging(HR-MRI)imaging in the assessment of intracranial aneurysms.Methods According to the diagnostic results of three dimensional digital subtraction angiography(DSA),60 cases of intracranial aneurysms rupture patients were divided into the wall of tumor with strengthening group(24cases)and the wall of tumor without strengthening group,the relationship between strengthening and the risk of intracranial aneurysm rupture,the feasibility of HR-MRI imaging technology in this area were analyzed.Results HR-MRI imaging of all the subjects before operation showed 41 patients with intracranial aneurysm rupture,the accuracy rate was 68.33%.The rate of intracranial aneurysm rupture in the wall of tumor with strengthening group(9.80%)was significant lower than that in the wall of tumor without strengthening group(18.42%)(χ~2=1.39,P<0.05).There were significant differences on cases without ascus and with ascus,cases with SR<2and SR≥2in the two groups(χ~2=5.62,926,P<0.05).Conclusion There was a little rate of missed diagnosis of HR-MRI imaging on intracranial aneurysm rupture.However,the imaging results showed that there was relationship between intracranial aneurysm rupture and the strengthening status of the wall of tumor,indicators infecting strengthening status of the wall of tumor including whether the tumor with or without ascus and SR.
Objective To investigate the feasibility of high resolution magnetic resonance imaging(HR-MRI)imaging in the assessment of intracranial aneurysms.Methods According to the diagnostic results of three dimensional digital subtraction angiography(DSA),60 cases of intracranial aneurysms rupture patients were divided into the wall of tumor with strengthening group(24cases)and the wall of tumor without strengthening group,the relationship between strengthening and the risk of intracranial aneurysm rupture,the feasibility of HR-MRI imaging technology in this area were analyzed.Results HR-MRI imaging of all the subjects before operation showed 41 patients with intracranial aneurysm rupture,the accuracy rate was 68.33%.The rate of intracranial aneurysm rupture in the wall of tumor with strengthening group(9.80%)was significant lower than that in the wall of tumor without strengthening group(18.42%)(χ~2=1.39,P<0.05).There were significant differences on cases without ascus and with ascus,cases with SR<2and SR≥2in the two groups(χ~2=5.62,926,P<0.05).Conclusion There was a little rate of missed diagnosis of HR-MRI imaging on intracranial aneurysm rupture.However,the imaging results showed that there was relationship between intracranial aneurysm rupture and the strengthening status of the wall of tumor,indicators infecting strengthening status of the wall of tumor including whether the tumor with or without ascus and SR.
引文
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[9]石士奎,朱广辉,张少军,等.多层螺旋CT血管成像评估颅内单发囊状动脉瘤破裂风险[J].中国介入影像与治疗学,2015,12(2):89-93.
[10]Matouk CC,Mandell DM,Gunel M,et al.Vessel wall magnetic resonance imaging identifies the site of rupture in patients with multiple intracranial aneurysms:proof of principle[J].Neurosurgery,2013,72(3):492-496.
[11]高佩虹,赵斌,王光彬.颅内动脉高分辨磁共振成像研究进展[J].国际医学放射学杂志,2012,35(4):331-333.
[12]王馨蕊,李晶,陆建平.颅内动脉瘤破裂机制及影像学风险评估研究进展[J].影像诊断与介入放射学,2015,24(1):84-87.
[2]GrevingJP,WermerMJ,BrownRDJr,et al.Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms:apooled analysis of six prospective cohort studies[J].Lancet Neurol,2014,13(1):59-66.
[3]李明利,徐蔚海,冯逢,等.磁共振颅内动脉斑块成像技术的临床应用[J].中国医学科学院学报,2012,34(5):443-449.
[4]吴艳,曾旭文,梁治平,等.颅内动脉瘤破裂CT血管成像诊断价值的Meta分析[J].实用放射学杂志,2014,30(12):1966.
[5]江国权,方兴根,徐善水,等.颅内动脉瘤破裂的血流动力学和形态学因素[J].介入放射学杂志,2014,23(12):1109-1113.
[6]蔡长寿.磁共振血管成像在颅内小动脉瘤诊断中的应用[J].南昌大学学报(医学版),2011,51(2):90-92.
[7]刘梦琦,马宁,姜卫剑,等.颅内动脉粥样硬化三维流动散相磁共振成像的可行性[J].中国卒中杂志,2012,7(11):839-844.
[8]王蕾.三维时间飞越法磁共振血管成像序列及数字减影血管造影在颅内动脉瘤诊断中的对比研究[J].山西医药杂志,2012,41(12):1212-1213.
[9]石士奎,朱广辉,张少军,等.多层螺旋CT血管成像评估颅内单发囊状动脉瘤破裂风险[J].中国介入影像与治疗学,2015,12(2):89-93.
[10]Matouk CC,Mandell DM,Gunel M,et al.Vessel wall magnetic resonance imaging identifies the site of rupture in patients with multiple intracranial aneurysms:proof of principle[J].Neurosurgery,2013,72(3):492-496.
[11]高佩虹,赵斌,王光彬.颅内动脉高分辨磁共振成像研究进展[J].国际医学放射学杂志,2012,35(4):331-333.
[12]王馨蕊,李晶,陆建平.颅内动脉瘤破裂机制及影像学风险评估研究进展[J].影像诊断与介入放射学,2015,24(1):84-87.