3.0T高分辨率磁共振成像对中青年大脑中动脉狭窄性病变的诊断价值
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摘要
目的探讨3.0T高分辨率磁共振成像(HR MRI)对中青年大脑中动脉狭窄性病变的诊断价值。方法选择2013年1月至2017年12月于我院就诊的88例大脑中动脉狭窄性病变中青年患者,均进行数字减影血管造影(DSA)和3.0T HR MRI检查,分析3.0THRMRI对中青年大脑中动脉狭窄性病变的诊断价值。结果共分析88例患者162支大脑中动脉,与DSA结果相比,3.0THRMRI对中青年大脑中动脉轻度狭窄诊断轻度狭窄、中度狭窄、重度狭窄和闭塞诊断灵敏度为分别90.70%、90.30%、84.62%、100%,特异度分别为97.48%、93.64%、98.53%、99.34%,准确度分别为95.68%、92.59%、96.30%、99.38%,诊断一致性分别为0.888、0.832、0.858、0.949。3.0THRMRI检查显示162支大脑中动脉存在稳定斑块者87支,存在不稳定斑块者75支,其中稳定性斑块纤维帽多完整,无脂质核心和斑块内出血;部分不稳定斑块可见脂质核心和斑块内出血。结论3.0THRMRI对中青年大脑中动脉狭窄程度诊断信效度高,与DSA结果一致性好,可清晰显示大脑中动脉斑块、评估斑块稳定程度,对中青年大脑中动脉狭窄性病变诊断具有积极价值。
Objective To investigate the value of 3.0 T high-resolution magnetic resonance imaging(HR MRI) in the diagnosis of middle cerebral artery stenosis in young and middle-aged patients. Methods Eighty-eight young and middle-aged patients with middle cerebral artery stenosis who were admitted to the hospital from January 2013 to December 2017 were enrolled in the study. Digital subtraction angiography(DSA) and 3.0 T HR MRI were performed and the value of 3.0 T HR MRI in the diagnosis of middle cerebral artery stenosis in young and middle-aged patients was analyzed. Results A total of 162 middle cerebral arteries were examined in 88 patients. Compared with results of DSA, the sensitivities of 3.0 T HR MRI in the diagnosis of mild stenosis, moderate stenosis, severe stenosis and occlusion in young and middle-aged patients with middle cerebral artery stenosis were 90.70%, 90.30%, 84.62% and 100%, respectively. The specificities were 97.48%, 93.64%, 98.53% and 99.34%, respectively. The accuracy rates were 95.68%, 92.59%, 96.30% and 99.38%, respectively, and the diagnostic consistency was 0.888, 0.832, 0.858 and 0.949, respectively. 3.0 T HR MRI showed that there were 87 stable plaques and 75 unstable plaques in 162 middle cerebral arteries. The fiber cap the stable plaque was intact, without lipid core or bleeding in plaques. Some unstable plaques showed lipid core and bleeding in plaques. Conclusion 3.0 T HR MRI is of high reliability and validity in the diagnosis of young and middle-aged patients with middle cerebral artery stenosis, with good consistency with results of DSA. It can clearly show the middle cerebral artery plaques and is of positive value for the diagnosis of cerebral artery stenosis in young and middle-aged patients.
Objective To investigate the value of 3.0 T high-resolution magnetic resonance imaging(HR MRI) in the diagnosis of middle cerebral artery stenosis in young and middle-aged patients. Methods Eighty-eight young and middle-aged patients with middle cerebral artery stenosis who were admitted to the hospital from January 2013 to December 2017 were enrolled in the study. Digital subtraction angiography(DSA) and 3.0 T HR MRI were performed and the value of 3.0 T HR MRI in the diagnosis of middle cerebral artery stenosis in young and middle-aged patients was analyzed. Results A total of 162 middle cerebral arteries were examined in 88 patients. Compared with results of DSA, the sensitivities of 3.0 T HR MRI in the diagnosis of mild stenosis, moderate stenosis, severe stenosis and occlusion in young and middle-aged patients with middle cerebral artery stenosis were 90.70%, 90.30%, 84.62% and 100%, respectively. The specificities were 97.48%, 93.64%, 98.53% and 99.34%, respectively. The accuracy rates were 95.68%, 92.59%, 96.30% and 99.38%, respectively, and the diagnostic consistency was 0.888, 0.832, 0.858 and 0.949, respectively. 3.0 T HR MRI showed that there were 87 stable plaques and 75 unstable plaques in 162 middle cerebral arteries. The fiber cap the stable plaque was intact, without lipid core or bleeding in plaques. Some unstable plaques showed lipid core and bleeding in plaques. Conclusion 3.0 T HR MRI is of high reliability and validity in the diagnosis of young and middle-aged patients with middle cerebral artery stenosis, with good consistency with results of DSA. It can clearly show the middle cerebral artery plaques and is of positive value for the diagnosis of cerebral artery stenosis in young and middle-aged patients.
引文
[1]黄维,毕齐.青年缺血性脑卒中病因学筛查研究现状[J].中国全科医学,2015,18(12):1355-1360.
[2]武宝华,任转勤,田宏哲,等.MSCTA对比DSA、MRA诊断颅内动脉瘤的临床应用价值[J].实用放射学杂志,2015,31(11):1848-1851.
[3]李星亮,杨笑一,张玉强,等.评估颈内动脉颅内段血管狭窄三种影像学方法的对比分析[J].介入放射学杂志,2014,23(4):333-336.
[4]Kasner S E,Lynn M J,Chimowitz MI,et al.Warfarin vs aspirin for symptomatic intracranial stenosis:subgroup analyses from WASID[J].Neurology,2006,67(7):1275.
[5]Samuels O B,Joseph G J,Lynn MJ,et al.A standardized method for measuring intracranial arterial stenosis[J].Ajnr Am JNeuroradiol,2000,21(4):643-646.
[6]林小慧,刘开祥,曾爱源,等.170例脑梗死患者数字减影血管造影结果分析[J].中国老年学,2014,34(1):196-197.
[7]张圆圆,孟秀君,田沈,等.颈部彩色多普勒超声、CT血管成像与数字减影血管造影诊断颈内动脉狭窄、斑块形态及溃疡的准确性比较[J].中国全科医学,2015,18(30):3763-3768.
[8]王丽华,管霞,孟磊,等.高分辨磁共振血管成像在检测症状性颈动脉狭窄中的诊断价值[J].中国CT和MRI杂志,2018,16(3):14-16.
[9]刘敬禹,宋涛,马超,等.3.0T高分辨率磁共振成像评估动脉粥样硬化性大脑中动脉狭窄[J].第二军医大学学报,2014,35(10):1141-1144.
[10]黄俊,郭富强,陈士跃,等.大脑中动脉粥样硬化狭窄的3.0T HR-MRI和DSA比较研究[J].中国临床医学影像杂志,2014,25(8):551-554.
[11]王红燕,纪盛章,冯莹印,等.颈动脉斑块和狭窄与缺血性脑卒中相关性分析[J].实用放射学杂志,2015,31(4):552-555.
[12]谢珊珊,张勇.高分辨率MRI在大脑中动脉粥样硬化性狭窄的应用[J].实用放射学杂志,2014,30(1):167-169.
[13]钱秋平,王苇,李澄,等.高分辨率MRI对脑动脉粥样硬化的诊断价值[J].临床神经病学杂志,2012,25(2):107-110.
[2]武宝华,任转勤,田宏哲,等.MSCTA对比DSA、MRA诊断颅内动脉瘤的临床应用价值[J].实用放射学杂志,2015,31(11):1848-1851.
[3]李星亮,杨笑一,张玉强,等.评估颈内动脉颅内段血管狭窄三种影像学方法的对比分析[J].介入放射学杂志,2014,23(4):333-336.
[4]Kasner S E,Lynn M J,Chimowitz MI,et al.Warfarin vs aspirin for symptomatic intracranial stenosis:subgroup analyses from WASID[J].Neurology,2006,67(7):1275.
[5]Samuels O B,Joseph G J,Lynn MJ,et al.A standardized method for measuring intracranial arterial stenosis[J].Ajnr Am JNeuroradiol,2000,21(4):643-646.
[6]林小慧,刘开祥,曾爱源,等.170例脑梗死患者数字减影血管造影结果分析[J].中国老年学,2014,34(1):196-197.
[7]张圆圆,孟秀君,田沈,等.颈部彩色多普勒超声、CT血管成像与数字减影血管造影诊断颈内动脉狭窄、斑块形态及溃疡的准确性比较[J].中国全科医学,2015,18(30):3763-3768.
[8]王丽华,管霞,孟磊,等.高分辨磁共振血管成像在检测症状性颈动脉狭窄中的诊断价值[J].中国CT和MRI杂志,2018,16(3):14-16.
[9]刘敬禹,宋涛,马超,等.3.0T高分辨率磁共振成像评估动脉粥样硬化性大脑中动脉狭窄[J].第二军医大学学报,2014,35(10):1141-1144.
[10]黄俊,郭富强,陈士跃,等.大脑中动脉粥样硬化狭窄的3.0T HR-MRI和DSA比较研究[J].中国临床医学影像杂志,2014,25(8):551-554.
[11]王红燕,纪盛章,冯莹印,等.颈动脉斑块和狭窄与缺血性脑卒中相关性分析[J].实用放射学杂志,2015,31(4):552-555.
[12]谢珊珊,张勇.高分辨率MRI在大脑中动脉粥样硬化性狭窄的应用[J].实用放射学杂志,2014,30(1):167-169.
[13]钱秋平,王苇,李澄,等.高分辨率MRI对脑动脉粥样硬化的诊断价值[J].临床神经病学杂志,2012,25(2):107-110.