T1SPACE技术诊断Cockett综合征的临床应用价值

Clinical value of T1 SPACE technique in the diagnosis of Cockett syndrome

目的 探讨T1 SPACE技术诊断Cockett综合征的临床应用价值。方法 收集我院患有慢性下肢静脉疾病且临床考虑Cockett综合征的患者96例,在行数字减影血管造影检查前2 d内行非增强磁共振血管检查。在T1 SPACE序列上测量患侧髂总静脉受压狭窄处前后径和健侧髂总静脉远端分叉处前后径,并计算出狭窄率,观察盆腔内侧支血管显影情况。以数字减影血管造影检查结果为金标准,计算最大约登指数下对应的狭窄率,采用ROC曲线评估最大约登指数下单独运用髂总静脉狭窄率及狭窄率联合侧支血管对Cockett综合征的诊断效能。结果 在T1 SPACE图像上髂总静脉平均狭窄率为(47.77±21.16)%。以狭窄率作为诊断Cockett综合征的标准,ROC曲线下面积为0.738,取最大约登指数对应狭窄率43.85%作为诊断截点,敏感性为63.90%,特异性为83.30%,诊断符合率为68.75%;以髂静脉狭窄率≥43.85%联合侧支血管显像作为诊断标准,ROC曲线下面积为0.867,敏感性为90.10%,特异性为83.30%,诊断符合率87.50%,两者差异有统计学意义(P<0.05)。结论 在T1 SPACE技术检查中,髂静脉受压狭窄率对Cockett综合征有较好的诊断效能,狭窄率联合侧支血管能进一步提高磁共振对Cockett综合征的诊断效能,T1 SPACE技术具有较好的临床应用价值。

Objective To explore the clinical value of T1 SPACE technique in the diagnosis of Cockett syndrome.Methods Clinical data of 96 patients with chronic lower extremity venous disease and clinically suspected Cockett syndrome in our hospital who underwent non-contrast magnetic resonance angiography within 2 days before digital subtraction angiography were collected.The anteroposterior diameter of the compressed stenosis of the ipsilateral common iliac vein and the anteroposterior diameter of the distal bifurcation of the unaffected common iliac vein were measured on T1 SPACE sequence.The stenosis rate was calculated, and the situation of pelvic medial branch vessels was observed.The corresponding stenosis rate under the maximum Youden index was calculated by using the results of digital subtraction angiography as the gold standard.The ROC curve was used to evaluate the diagnostic efficacy of the common iliac vein stenosis rate and stenosis rate combined with collateral vessels on Cockett syndrome.Results The average stenosis rate of the common iliac vein on T1 SPACE images was(47.77±21.16)%.Taking the stenosis rate as the criterion for the diagnosis of Cockett syndrome, the area under the ROC curve was 0.738.The stenosis rate was 43.85% corresponding to the maximum Youden index and it was taken as the diagnostic cut-off point.The sensitivity was 63.90%, the specificity was 83.30%, and the diagnostic coincidence rate was 68.75%.Taking the iliac vein stenosis rate ≥43.85% combined with collateral vessel imaging as the diagnostic criteria, the area under the ROC curve was 0.867, the sensitivity was 90.10%, the specificity was 83.30%, and the diagnostic coincidence rate was 87.50%.The difference between the two methods was statistically significant(P<0.05).Conclusion The iliac vein compression stenosis rate has a good efficiency in the diagnosis of Cockett syndrome, and the stenosis rate combined with collateral vessels can further improve the diagnostic efficiency with T1 SPACE technique, T1 SPACE technique has good clinical value.