颅内静脉窦2D-TOF MR和3D-CE MRA扫描方法对比研究

2D-TOF MR and 3D-CE MRA scan method of intracranial venous sinus comparison study

目的比较2D-TOF MRA和3D-CE MRA在颅内静脉窦显示的方法研究,比较两种扫描方法的优缺点。材料与方法对我院2013年10月至2014年3月随机抽取了共100例行颅内静脉血管成像(同时采用2D-TOF MRA与3D-CE MRA)的患者进行研究分析。综合评价2D-TOF MRA技术与3D-CE MRA技术对颅内静脉窦的显示能力,以便正确的选出一种对颅内静脉窦达到较好的显示效果的方法。选择条件:(1)能较好的显示颅内静脉窦的形态,窦汇区的连接方式。(2)能较好的显示颅内静脉窦病变,体现在颅内病变中的应用价值。(3)考虑病人自身条件和经济条件基础上,选择恰当的扫描方法。结果 2D-TOF MRA能够清楚显示颅内静脉窦50例,显示不清或没有显示为50例;3D-CE MRA能够清楚显示8 4例,显示不清或没有显示为1 6例,两者比较有统计学差异(χ2=2 6.1 4 2,P=0.001)。2D-TOF MRA诊断颅内静脉窦病变准确率88%(88/100),灵敏度66.7%(16/24),特异度94.7%(72/76),阳性预测值及阴性预测值分别为80%(16/20)、90%(72/80);3D-CE MRA诊断颅内静脉窦病变准确率92%(92/100),灵敏度75%(18/24),特异度97.4%(74/76),阳性预测值及阴性预测值分别为81.8%(18/22)、92.5%(74/80)。结论 3D-CE MRA在横窦以及乙状窦的显示中优于2D-TOF MRA,同时能明确显示及诊断颅内静脉窦,但是3D-CE MRA使用对比剂,其危险性和费用也同时增加。

Objective： To study the comparison of 2D-TOF MRA and 3D-CE MRA in intracranial venous sinus,comparing the advantages and disadvantages of two kinds of scanning method. Materials and Methods： In our hospital between October 2013 and March 2014,we randomly selected 100 cases intracranial venous blood vessel imaging（at the same time using 2D-TOF MRA with 3D-CE MRA） through analyzing the patients. We comprehensively evaluate the ability of 2D-TOF MRA technology and3D-CE MRA technology on the display of intracranial venous sinus in order to correctly select a method of intracranial venous sinus to get better display effect. Selection criteria： 1 to display the intracranial venous sinus shape better,and the connection way of torcular region. 2 to display the intracranial venous sinus lesions better,reflect the application value in the intracranial lesions. 3 to considerate the patient＇s own conditions and economic conditions,choose the appropriate scanning method. Results： 2D-TOF MRA can clearly show the intracranial venous sinus 50 cases,and the other 50 cases were failed to be showed clearly. 3D-CE MRA can clearly show 84 cases,fail to show clearly 16 cases,comparison between 2D-TOF MRA and 3D-CE MRA has statistical significance（χ^2= 26.142,P=0.001）. The accuracy rate of 2D-TOF MRA in the diagnosis of intracranial venous sinus disease was 88%（88/100）,the sensitivity was 66.7%（16/24） and specifi city was 94.7%（72/76）,positive predictive value and negative predictive values were 80%（16/20）,90%（72/80）. The accuracy rate of 3D-CE MRA in the diagnosis of intracranial venous sinus disease was 92%（92/100）,the sensitivity was 75%（18/24） and the specifi city was 97.4%（74/76）,positive predictive value and negative predictive value were 81.8%（18/22）,92.5%（74/80）. Conclusions： 3D-CE MRA was able to clearly display and diagnose intracranial venous sinus,and better than 2D-TOF MRA in the transverse sinus and sigmoid sinus display,but the use of comtrast agents in 3D-CE MRA makes its risks and costs increase.