大脑中动脉狭窄的3D-VISTA诊断价值

The Diagnostic Value of 3D Volumetric Isotropic TSE Acquisition in Evaluating Middle Cerebral Artery Stenosis

目的探讨三维容积各向同性快速自旋回波(3D-VISTA)技术在大脑中动脉狭窄中的诊断价值。方法对37例经MR血管造影(MRA)或CT血管造影(CTA)诊断的大脑中动脉M1段不同程度狭窄或闭塞的患者进行3D-VISTA进一步检查,并与介入治疗时的数字减影血管造影(DSA)检查进行对比,计算3D-VISTA及DSA检查的血管狭窄率,同时观察狭窄处管壁在3D-VISTA上的图像特点。结果 37例患者有33支大脑中动脉的3D-VISTA图像质量符合测量要求,与DSA测量的血管狭窄率相关性好(r=0.943,P<0.01),以DSA作为金标准,两者一致性较高(Kappa值0.86,P<0.01)。在3D-VISTA图像上表现为狭窄的27支大脑中动脉中,21支出现管壁偏心性增厚,3支环形增厚;另有1支向心性增厚并环形强化,2支管壁仅见狭窄改变。结论 3D-VISTA在大脑中动脉狭窄的诊断方面与DSA相比有良好的一致性和相关性,并且可以提供狭窄处管壁的相关信息,对大脑中动脉狭窄病因的鉴别提供一定的帮助。

Objective To explore the diagnostic value of 3D Volumetric Isotropic TSE Acquisition in evaluating middle cerebral artery （MCA） stenosis. Methods 37 patients with MCA stenosis or occlusion, which were diagnosed by MRA or CTA, underwent both 3 D-VISTA and DSA examinations. The rate of stenosis was compared between 3D-VISTA and DSA and the wall of MCA on 3D-VISTA was also evaluated. Results Among 37 patients,33 arteries showed good relevance of DSA, correlation rate was 0. 943 （P 〈 0.01 ）. Based on the results of DSA, the gold standard, two imaging modalities conformed well in evaluating MCA stenosis （Kappa =0. 86, P 〈0.01 ）. Stenosis was detected in 27 arteries on 3D-VISTA, 24 arteries had wall thickness, among them eccentric narrow lesions were detected in 21 arteries, 3 arteries presented annular thickness. Centrality narrow and enhanced lesion in 1 artery, the other two arteries only presented narrow without wall thickness. Conclusion In evaluating MCA stenosis or occlusion, 3D-VISTA is well consistent with DSA. Besides that 3D-VISTA can effectively present the components of narrow artery wall, which offers a great help in the differential diagnosis of the cause of MCA stenosis.