大脑中动脉高密度征与磁敏感血管征对大脑中动脉闭塞评估的一致性

Consistency of hyperdense middle cerebral artery sign and susceptibility vessel sign for the assessment of middle cerebral artery occlusion

目的探讨CT平扫大脑中动脉高密度征(HMCAS)与磁敏感加权成像大脑中动脉(MCA)磁敏感血管征(SVS)的一致性。方法回顾性连续纳入150例发病6 h内前循环脑梗死急性期患者,均接受头部CT、MRI一站式检查,并记录患者基线情况。对CT及MRI进行分析,记录HMCAS、SVS存在情况,共有75例与DSA结果进行对照;HMCAS与SVS的一致性采用Kappa检验并行假设u检验。结果以DSA为参照标准,HMCAS和SVS对急性MCA主干闭塞的敏感度、特异度分别为42.4%(14/33)、36.4%(12/33)和92.9%(39/42)、90.5%(38/42);HMCAS与SVS的一致性检验值κ=0.804,u值为9.570(P<0.05)。结论 MCA的HMCAS与SVS呈高度一致性,可为急性缺血性卒中的早期诊断、治疗方式的选择及溶栓后血管再通预测提供参考依据。

Objective To investigate the consistency of hyperdense middle cerebral artery sign（ HMCAS） with CT scan and susceptibility vessel sign（ SVS） with susceptibility weighted imaging.Methods A total of 150 consecutive patients with acute anterior circulation cerebral infarction within 6 h of onset were enrolled retrospectively. They all received CT and one-stop MRI,and the baseline of the patients were documented. The CT and MRI findings were analyzed. The presence of HMCAS and SVS were documented. A total of 75 patients were compared with the DSA findings. The consistency of HMCAS and SVS used Kappa test,and conducted a hypothetical u test. Results Taking DSA as the reference standard,the sensitivity and specificity of HMCASand SVS for acute MCA trunk occlusion were 42. 4%（ 14 /33） and36. 4%（ 12 /33）,92. 9%（ 39 /42） and 90. 5%（ 38 /42）,respectively. The consistency test value of HMCAS and SVS was κ = 0. 804,and the u value was 9. 570（ P〈0. 05）. Conclusions HMCAS of MCA shows highly consistent with SVS. It can provide reference basis for early diagnosis,treatment options,and recanalization prediction after thrombolysis in acute ischemic stroke.