高分辨率磁共振和彩色多普勒超声诊断颈动脉斑块的比较研究

A Comparative Study between High-resolution MRI and Color Doppler Ultrasound in Diagnosing Carotid Artery Plaques

目的比较高分辨率亮血及黑血磁共振与彩色多普勒超声评估颈动脉斑块及颈动脉狭窄的诊断价值。方法对102例临床怀疑存在颅外颈动脉狭窄的患者同时行高分辨率亮血及黑血磁共振检查与彩色多普勒超声检查(其中35例1月内行数字化减影血管造影术),根据病变狭窄程度分为1~4级,进行2种检查方法的相关性比较,并以数字化减影血管造影术作为金标准,分析其诊断的准确性。结果超声与高分辨率磁共振诊断血管狭窄程度的相关性密切(Rs=0.95,P<0.01)。高分辨率磁共振诊断≥50%狭窄的敏感性、特异性和准确度分别为94.6%、100%和99.0%,而超声分别为89.2%、100%和98.1%。另外超声未能分析出3例斑块的表面溃疡。结论高分辨率磁共振和彩色多普勒超声联合应用可以提高颈动脉斑块的检出及狭窄程度的诊断准确性,预防缺血性脑卒中的发生。

Objective To compare the diagnostic value of high-resolution bright-blood and black-blood MRI withthat of color Doppler ultrasound in the evaluation of carotid artery plaques and carotid stenosis. Both high-resolutionbright-blood and black-blood MRI and color Doppler ultrasound examinations were performed to 102 suspicious cases, out ofthe 102,35 cases received digital substraction angiography （DSA） within 1 month; the stenosis was graded into 4, （Degree1,2,3 and 4）; the correlation between the2 imaging techniques was studied and their diagnostic accuracy was analyzed, takingDSA as the golden standard. There existed a close correlation between ultrasound and high-resolution MRI in diag-nosing the degrees of artery stenosis （Rs=0.95, 〈0.01）; the sensitivity, specificity and accuracy of high-resolution MRIin diagnosing over 50% artery stenosis were 94.6%, 100% and 99.0% respectively while those of ultrasound were 89.2%,100% and 98.1% respectively; ultrasound examination failed to find out the superficial ulcers of3 plaques. Thecombined application of high-resolution MRI and color Doppler ultrasound can raise the accuracy in diagnosing carotid arteryplaques and the degrees of artery stenosis, which is of great help in preventing the occurrence of ischemic stroke.