脑血管狭窄与闭塞的MRA与DSA对照研究

A Comparative Study of MRA and DSA in Intracranial Vascular Stenosis and Occlusion

目的：评价ＭＲＡ诊断脑血管狭窄与闭塞的价值及限度，并对假阳性、假阴性进行分析。材料与方法：对１４例患者的１２０根正常、狭窄与闭塞血管进行３ＤＴＯＦＭＯＴＳＡＭＲＡ和ＤＳＡ对照分析。结果：１４例１２０根血管ＭＲＡ与ＤＳＡ诊断相符合血管数为１０９根（９０．８％），ＭＲＡ对正常脑血管的敏感性、特异性、准确性分别为９１％、９０．３％、９０．８％；对狭窄血管分别为８３．３％、９２．１％、９０．８％；对闭塞血管分别为１００％、９６％、１００％。结论：ＭＲＡ对评价正常脑血管和闭塞脑血管精确性较高，而对颅内狭窄血管的评价不及ＤＳＡ，特别是颈内动脉虹吸部和大脑中动脉Ｍ１、Ｍ２的评价存在假阳性或假阴性，因此ＭＲＡ可用于筛选可疑颅内动脉狭窄或闭塞的患者。

Objective: To determine the value of MRA in the detection intracranial steno occlusive vessels, and analyse the reasons for false positive or false negative result.Materials and Methods:14 patients with a total of 120 arteries which were normal or stenosis occlusive were assessed by 3D TOF MOTSA MRA and DSA. Results:The MRA readings correlated with DSA findings in 109 vessels (90.8%), the MRA sensitivity, specificity and accuracy for normal vessels were 91%, 90.3%, 90.8% respectively, for stenosis vessels were 83.3%, 92,1%, 90.8% and 100%, 96%, 100% respectively for occlusive vessels. Conclusion: For normal and occlusive vessels, excellent agreements were found in both MRA and DSA, and MRA proved to be less useful for identification of stenosis vessels, especially in the carotid siphon and M 1M 2 segments of middle cerebral artery which have false positive and false negative results, so MRA could be used as a screening method for suspected intracranial steno occlusive vessels, in order to avoid or decrease the times of DSA.