T1WI 3D-VISTA在大脑中动脉狭窄中的诊断价值
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摘要
目的:探讨T1加权三维容积各向同性快速自旋回波成像(T1-weighted 3D-volumetric isotropic TSE acquisition,T1WI3D-VISTA)在大脑中动脉(middle cerebral artery,MCA)狭窄中的诊断价值。方法:回顾性分析本院2016年5月至2017年7月因怀疑MCA狭窄行磁共振时间飞跃法血管成像(time of flight magnetic resonance angiography,TOF-MRA)和T1WI 3D-VISTA检查并经数字减影血管造影(digital subtraction angiography,DSA)验证确诊为狭窄的33名患者图像。将所得图像由2位高年资放射医师采用盲法阅片,对T1WI 3D-VISTA图像质量进行评分并测量血管狭窄率。利用SPSS 17.0软件进行统计学分析,采用随机单位组方差分析对比T1WI 3D-VISTA、TOF-MRA和DSA三者的测量结果,组间比较采用LSD-t检验;以DSA为金标准对比T1WI 3D-VISTA和TOF-MRA对狭窄的显示情况并计算T1WI 3D-VISTA诊断狭窄的敏感度、特异度等参数。结果:33例病人共计37支MCA检出不同程度狭窄或闭塞;T1WI 3D-VISTA、TOF-MRA和DSA测得的平均狭窄率分别为(63.189±16.050)%、(66.014±15.395)%和(61.351±16.366)%,差异有统计学意义(F=5.443,P=0.006),T1WI 3D-VISTA和TOF-MRA之间差异无统计学意义(P=0.050),DSA和T1WI 3D-VISTA之间差异无统计学意义(P=0.200),DSA和TOF-MRA之间差异有统计学意义(P=0.001)。T1WI 3D-VISTA和DSA诊断MCA狭窄程度的一致性好(κ=0.874,P=0.000),TOF-MRA和DSA诊断MCA狭窄程度的一致性一般(κ=0.593,P=0.000)。结论:T1WI 3D-VISTA技术在诊断MCA狭窄中与DSA有很好的一致性,对MCA狭窄有较好的诊断价值。
Objective:To evaluate the diagnostic value of T1-weighted 3D-volumetric isotropic TSE acquisition(T1WI 3D-VISTA)in middle cerebral artery(MCA) stenosis. Methods:The time of flight magnetic resonance angiography(TOF-MRA) and T1WI 3D-VISTA images of 33 patients who were proved have MCA stenosis by digital subtraction angiography(DSA)from May 2016 to July2017 were retrospectively analyzed. The images were estimated by two experienced radiologists to score the image quality of T1WI3D-VISTA and measure the vascular stenosis rate blindly. SPSS 17.0 software was used for statistical analysis. Randomized blocks of variance and LSD-t test were used for analyzing the stenosis rate of T1WI 3D-VISTA,TOF-MRA and DSA. The consistency between T1WI 3D-VISTA and DSA with TOF-MRA and DSA was compared and the sensitivity,specificity and other parameters of T1WI3D-VISTA was calculated using DSA as the gold standard. Results:Totally 37 arteries were diagnosed with varying degrees of stenosis or occlusion. The mean stenosis rates of T1WI 3D-VISTA,TOF-MRA and DSA were(63.189±16.050)%,(66.014±15.395)%and(61.351±16.366)% respectively,with statistically significant difference(F=5.443,P=0.006). There was no significant difference between T1WI 3D-VISTA and TOF-MRA(P=0.050),between T1WI 3D-VISTA and DSA(P=0.200),while the stenosis rates of TOF-MRA was significantly higher than that of DSA(P=0.001). A good consistency between T1WI 3D-VISTA and DSA(κ=0.874,P=0.000)while a middle consistency between TOF-MRA and DSA(κ=0.593,P=0.000)was observed. Conclusion:The T1WI 3DVISTA technique has a good consistency with DSA in diagnosing MCA stenosis,and it has a good diagnostic value for MCA stenosis.
Objective:To evaluate the diagnostic value of T1-weighted 3D-volumetric isotropic TSE acquisition(T1WI 3D-VISTA)in middle cerebral artery(MCA) stenosis. Methods:The time of flight magnetic resonance angiography(TOF-MRA) and T1WI 3D-VISTA images of 33 patients who were proved have MCA stenosis by digital subtraction angiography(DSA)from May 2016 to July2017 were retrospectively analyzed. The images were estimated by two experienced radiologists to score the image quality of T1WI3D-VISTA and measure the vascular stenosis rate blindly. SPSS 17.0 software was used for statistical analysis. Randomized blocks of variance and LSD-t test were used for analyzing the stenosis rate of T1WI 3D-VISTA,TOF-MRA and DSA. The consistency between T1WI 3D-VISTA and DSA with TOF-MRA and DSA was compared and the sensitivity,specificity and other parameters of T1WI3D-VISTA was calculated using DSA as the gold standard. Results:Totally 37 arteries were diagnosed with varying degrees of stenosis or occlusion. The mean stenosis rates of T1WI 3D-VISTA,TOF-MRA and DSA were(63.189±16.050)%,(66.014±15.395)%and(61.351±16.366)% respectively,with statistically significant difference(F=5.443,P=0.006). There was no significant difference between T1WI 3D-VISTA and TOF-MRA(P=0.050),between T1WI 3D-VISTA and DSA(P=0.200),while the stenosis rates of TOF-MRA was significantly higher than that of DSA(P=0.001). A good consistency between T1WI 3D-VISTA and DSA(κ=0.874,P=0.000)while a middle consistency between TOF-MRA and DSA(κ=0.593,P=0.000)was observed. Conclusion:The T1WI 3DVISTA technique has a good consistency with DSA in diagnosing MCA stenosis,and it has a good diagnostic value for MCA stenosis.
引文
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[3]Summers PE,Jarosz JM,Markus H.Mr angiography in cerebrovascular disease[J].Clin Radiol,2001,56(6):437-456.
[4]张鹤,李明华,方淳,等.3T TOF MRA在颅内血管病变中的应用——与DSA对照[J].中国医学计算机成像杂志,2008,14(5):437-441.
[5]Demaerel P,De Ruyter N,Maes F,et al.Magnetic resonance angiography in suspected cerebral vasculitis[J].Eur Radiol,2004,14(6):1005-1012.
[6]李明珠,徐敏,奚克敏.64-SCTA、MRA、DSA诊断脑血管狭窄对比研究[J].中国医疗设备,2009,24(7):138-140.
[7]Qiao Y,Zeiler SR,Mirbagheri S,et al.Intracranial plaque enhancement in patients with cerebrovascular events on high-spatial-resolution MR images[J].Radiology,2014,271(2):534-542.
[8]苑纯,赵锡海.易损斑块磁共振成像:共识与挑战[J].磁共振成像,2016,1(6):429-431.
[9]李明利,徐蔚海,宋兰,等.高分辨率磁共振成像诊断颅内动脉粥样硬化[J].中国医学影像技术,2010,26(6):1009-1012.
[10]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):25-27.
[11]Zhu XJ,Wang W,Du B,et al.Wall imaging for unilateral intracranial vertebral artery hypoplasia with three-dimensional high-isotropic resolution magnetic resonance images[J].Chin Med J(Engl),2015,128(12):1601-1606.
[12]Ryu CW,Jahng GH,Kim EJ,et al.High resolution wall and lumen MRI of the middle cerebral arteries at 3 tesla[J].Cerebrovasc Dis,2009,27(5):433-442.
[13]Samuels OB,Joseph GJ,Lynn MJ,et al.A standardized method for measuring intracranial arterial stenosis[J].AJNR Am J Neuroradiol,2000,21(4):643-646.
[14]Gao T,Yu W,Liu C.Mechanisms of ischemic stroke in patients with intracranial atherosclerosis:a high-resolution magnetic resonance imaging study[J].Exp Ther Med,2014,7(5):1415-1419.
[15]Bendszus M,Koltzenburg M,Burger R,et al.Silent embolism in diagnostic cerebral angiography and neurointerventional procedures:a prospective study[J].Lancet,1999,354(9190):1594-1597.
[16]高扬.CTA对冠状动脉粥样硬化病变进展的研究[D].北京:北京协和医学院中国医学科学院,2012:1-108.
[17]吴靖雯,王显龙,黄凡衡,等.大脑中动脉狭窄的3D-VISTA诊断价值[J].临床放射学杂志,2016 35(1):8-12.
[18]Cuvinciuc V,Viallon M,Momjian-Mayor I,et al.3D fat-saturated T1 SPACE sequence for the diagnosis of cervical artery dissection[J].Neuroradiology,2013,55(5):595-602.
[19]Qiao Y,Steinman DA,Qin Q,et al.Intracranial arterial wall imaging using three-dimensional high isotropic resolution black blood MRI at 3.0 Tesla[J].J Magn Reson Imaging,2011,34(1):22-30.