非对比增强四维MR血管成像评价脑动静脉畸形

Non-contrast-enhanced four-dimensional MR angiography in evaluation of cerebral arteriovenous malformation

目的评价非对比增强四维MRA(NCE 4DMRA)在评价脑动静脉畸形(AVM)中的价值。方法收集15例临床确诊且未经治疗的脑AVM患者,分别行NCE 4DMRA和DSA检查;观察AVM的供血动脉、畸形血管团大小及引流静脉,对比二者的诊断结果,并进行Kappa一致性检验。结果 DSA检查时所见的15例共15个AVM病灶NCE 4DMRA均可显示。DSA和MRA显示AVM供血动脉的一致性好(Kappa=0.92,P<0.001),判断畸形血管团大小的一致性较好(Kappa=0.69,P<0.001),显示引流静脉的一致性中等(Kappa=0.50,P<0.001)。结论 NCE 4DMRA能无创评价脑AVM的血管结构及血流动力学信息,具有潜在应用价值,但对引流静脉的显示效果有待改善。

Objective To observe the value of non-contrast-enhanced four-dimensional MRA （NCE 4D MRA） for the as- sessment of cerebral arteriovenous malformation （AVM）. Methods Fifteen patients with untreated cerebral AVM underwent 3.0T NCE 4D MRA and DSA, the arterial feeder, size and draining veins of AVM were observed. The results of NCE 4D MRA and DSA were compared, and Kappa coefficients were counted to determine the intermodality agreement between the two techniques. Results In 15 patients, 15 AVMs detected by DSA were visualized by NCE 4D MRA. The intermodality agreement between NCE 4D MRA and DSA was excellent for the arterial feeders （Kappa = 0.92, P〈 0. 001）, good for the lesion size （Kappa=0. 69, P〈0. 001）, while moderate for the draining veins （Kappa=0. 50, P〈 0. 001）. Conclusion NCE 4D MRA is a promising and potentially valuable method for noninvasive assessment of angioarchitecture and hemodynamics of cerebral AVM, though the depiction of draining veins for AVM needs to he improved.