摘要
目的:探讨三维动态对比增强磁共振血管成像(3D CE-MRA)在诊断下肢动脉硬化闭塞症(LEASD)中的应用价值。方法:收集临床诊断为LEASD的64例患者行下肢动脉3D CE-MRA及数字减影血管造影(DSA)检查,分析两者结果是否有差异。结果:以DSA金标准作为对照组,3D CE-MRA对下肢动脉狭窄及闭塞程度的分级与DSA比较,Kappa值为0.84≥0.75,一致性较好,差异无统计学意义(P>0.05);但3D CE-MRA对下肢动脉狭窄及闭塞有一定程度的高估及低估,对轻度狭窄、中度狭窄、重度狭窄的高估率分别为3.3%(11/332)、4.0%(5/125)、4.5%(5/112)。对中度狭窄、重度狭窄及闭塞的低估率分别为9.6%(12/125)、4.0%(5/112)、15%(20/132)。以DSA为标准,3D CE-MRA诊断下肢动脉狭窄及闭塞的敏感性、特异性、阳性预测值及阴性预测值分别为93.7%(701/753)、93.1%(563/605)、95.1%(701/737)、94.9%(563/599)。结论:3D CE-MRA下肢动脉成像是一种无创、无辐射、有效的血管检查方法,可作为LEASD的优选检查方法。
Objective: To investigate the application value of 3D CE-MRA in diagnosis of atherosclerosis occlusive disease of lower extremity. Methods: 64 patients which were diagnosed as LEASD by clinic underwent both 3D CE-MRA and DSA examination of bilateral arteries of lower extremity, and were analyzed if there were any difference between the results. Results: Taken DSA as the golden standard, the detection rate and grade of 3D CE-MRA in lower extremity artery stenosis and occlusion was compared with DSA. The value of Kappa 0. 84 ≥ 0. 75 and showed a good consistency with no statistical significance(P 0. 05). However, diagnosis of 3D CE-MRA in lower extremity artery stenosis and occlusion had over-estimation and under-estimation to some extent. The rate of over-estimation for slight stenosis, moderate stenosis, sever stenosis were respectively 3.3%(11/332), 4.0%(5/125), 4.5%(5/112). The rate of under-estimation for moderate stenosis, sever stenosis, occlusion were respectively 9.6%(12/125), 4.0%(5/112), 15%(20/132). Taken DSA as the standard, the sensitivity, specificity and positive predictive value and negative predictive value of 3D CE-MRA in lower extremity artery stenosis and occlusion were 93.7%(701/753), 93.1%(563/605), 95.1%(701/737), 94.9%(563/599). Conclusion: 3D CE-MRA of lower extremity artery is a nontraumatic, nonradioactive and effective vascular examination. It could be the optimizing examination for LEASD.
出处
《CT理论与应用研究(中英文)》
2015年第4期603-610,共8页
Computerized Tomography Theory and Applications
关键词
下肢动脉硬化闭塞症
三维动态对比增强磁共振血管成像
数字减影血管造影
lower extremity atherosclerosis disease
three-dimensional contrast-enhanced magnetic resonance angiography
digital subtraction angiography