高分辨磁共振血管壁成像在大脑中动脉粥样硬化疾病中的应用价值
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摘要
目的探讨高分辨磁共振血管壁成像在大脑中动脉粥样硬化疾病中的应用价值,为大脑中动脉粥样硬化疾病的早期诊断提供参考。方法选择2012年2月—2016年12月在我院诊治的缺血性脑卒中病人67例,进行数字减影血管造影(DSA)与高分辨磁共振血管壁成像,记录大脑中动脉狭窄情况,比较两种检查方法的效果。结果 67例病人共有134段大脑中动脉,124段(92.5%)磁共振血管壁成像与DSA诊断结果一致。相关分析显示:磁共振血管壁成像与DSA诊断大脑中动脉狭窄的相关性为0.978,Kappa值为0.893(P <0.05),两者诊断的相关性与一致性较好。高分辨磁共振血管壁成像对不同程度的大脑中动脉狭窄的阳性预测值、阴性预测值、灵敏性、特异性均>80.0%。结论高分辨磁共振血管壁成像在大脑中动脉粥样硬化疾病中的诊断具有很高的灵敏度和特异度,并与DSA检查有很好的相关性。
引文
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[3]QIAO Y,ANWAR Z,INTRAPIROMKUL J,et al.Patterns and implications of intracranial arterial remodeling in stroke patients[J].Stroke,2016,47(2):434-440.
[4]朱振国,黄艳君,陈艳艳,等.脑梗死伴颅内动脉粥样硬化性狭窄的影响因素分析[J].浙江医学,2016,38(13):1066-1068;1085.
[5]OKELL T W,SCHMITT P,BI X,et al.Optimization of 4Dvessel-selective arterial spin labeling angiography using balanced steady-state free precession and vessel-encoding[J].NMR Biomed,2016,29(6):776-786.
[6]ARAI D,SATOW T,KOMURO T,et al.Evaluation of the arterial wall in vertebrobasilar artery dissection using high-resolution magnetic resonance vessel wall imaging[J].J Stroke Cerebrovasc Dis,2016,25(6):1444-1450.
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[8]宋焱,李安琪,邓晓涛,等.磁共振血管壁成像技术对动脉粥样硬化兔模型斑块负荷评估的价值[J].中华老年医学杂志,2016,35(3):312-316.
[9]WARNERT E A,VERBREE J,WISE R G,et al.Using highfield magnetic resonance imaging to estimate distensibility of the middle cerebral artery[J].Neurodegener Dis,2016,16(5/6):407-410.
[10]CHUNG J W,BANG O Y,LEE M J,et al.Echoing plaque activity of the coronary and intracranial arteries in patients with stroke[J].Stroke,2016,47(6):1527-1533.
[11]霍成举,夏章勇,赵鑫,等.高分辨率磁共振在颅内动脉狭窄性疾病中的应用进展[J].中华老年心脑血管病杂志,2016,18(11):1227-1229.
[12]TAMURA G,IHARA S,MOROTA N.Reversible diffusion weighted imaging hyperintensities during the acute phase of ischemic stroke in pediatric moyamoya disease:a case report[J].Childs Nerv Syst,2016,32(8):1531-1535.
[13]LI M L,XU Y Y,HOU B,et al.High-resolution intracranial vessel wall imaging using 3D CUBE T1weighted sequence[J].Eur J Radiol,2016,85(4):803-807.
[14]许玉园,徐蔚海.高分辨磁共振神经病学应用进展[J].中国卒中杂志,2016,11(8):669-675.
[15]JIN H,GUO Z N,LUO Y,et al.Intracranial dermoid cyst rupture-related brain ischemia:case report and hemodynamic study[J].Medicine(Baltimore),2017,96(4):5631-5638.
[16]UMEMOTO T,PACCHIONI A,NIKAS D,et al.Recent developments of imaging modalities of carotid artery stenting[J].J Cardiovasc Surg(Torino),2017,58(1):25-34.
[17]唐小平,王志强,龚良庚,等.高分辨率血管壁MR对烟雾病与脑动脉粥样硬化的鉴别诊断[J].中国医学影像学杂志,2016,24(2):86-90.
[18]GON Y,SAKAGUCHI M,OYAMA N,et al.Diagnostic utility of contrast-enhanced 3DT1-weighted imaging in acute cerebral infarction associated with Graves disease[J].J Stroke Cerebrovasc Dis,2017,26(2):38-40.
[19]VERBREE J,BRONZWAER A,VAN BUCHEM M A,et al.Middle cerebral artery diameter changes during rhythmic handgrip exercise in humans[J].J Cereb Blood Flow Metab,2016,11(11):7189-7192.
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[21]JUNG S C,KIM H S,CHOI C G,et al.Quantitative analysis using high-resolution 3T MRI in acute intracranial artery dissection[J].J Neuroimaging,2016,26(6):612-617.
[22]JUNG S C,KIM H S,CHOI C G,et al.Spontaneous and unruptured chronic intracranial artery dissection:high-resolution magnetic resonance imaging findings[J].Clin Neuroradiol,2016,9(27):627-633.
[23]王婷婷,张磊,吴军,等.3.0T高分辨MRI对症状性大脑中动脉狭窄的诊断价值[J].中风与神经疾病杂志,2016,33(9):783-789.