3.0T TOF-MRA在支架辅助栓塞颅内动脉瘤术后随访中的应用研究

Application of 3.0T TOF MRA in the Follow-up of Endovascular Embolization for the Intracranial Aneurysm

目的评价3.0T TOF-MRA在支架辅助弹簧圈栓塞颅内动脉瘤术后随访中的应用价值。方法对32例在笔者医院行颅内动脉瘤支架辅助弹簧圈栓塞术后6个月~2年的患者进行影像学随访,行3.0T TOF-MRA及数字减影血管造影(DSA)检查。以DSA结果为金标准,对MRA的影像质量及结果进行比较分析。结果 (1)3.0T TOF-MRA判断支架辅助弹簧圈栓塞术后栓塞情况的准确度为37.5%,与DSA比较差异有统计学意义(P<0.05);结合原图像(SI)观察后,准确度提高到75.0%,与DSA比较差异无统计学意义(P>0.05)。(2)3.0T TOF-MRA对判断术后载瘤动脉通畅性的准确率为37.5%,与DSA比较差异有统计学意义(P<0.05)。结论 3.0T TOF-MRA结合原图像(SI)观察在评估支架辅助弹簧圈栓塞颅内动脉瘤术后栓塞情况的准确度高,可作为一种无创随访手段;但对判断载瘤动脉通畅性的准确度低,通过优化序列参数的方法可能得到改善。

Objective To evaluate the application of 3.0T TOF Magnetic resonance angiography （MRA） in the follow - up of the intracranial aneurysm with stent - assisted coil embolization. Methods In our hospital,32 patients who underwent intracranial aneurysm embolization with stent - assisted coil were followed up for 6m - 2y with radiologic examination. All patients were followed up with 3.0T TOF- MRA and Digital subtraction angiography（DSA） examination. DSA served as the golden standard. The MRA image quality and the results were compared. Results （ 1 ） The accuracy of 3.0T TOF - MRA to determine the situation of the intracranial aneurysms with em- bolization was 37.5% , there was significant difference compared with DSA （P 〈 0.05 ）. The accuracy improved to 75.0% Combinated with SI（ source image）, there was no significant difference Compared with DSA （P 〉 0.05 ）. （2）The accuracy of 3.0T TOF -MRA to de- termine the patency of the parent artery was 37.5% , there was significant difference compared with DSA （P 〈 0.05）. Conclusion The accuracy of 3.0T TOF - MRA ＋ SI to evaluate the situation of the intracranial aneurysms with stent - assisted coil embolization was high. We can use 3.0T TOF - MRA ＋ SI as a Noninvasive means for follow - up. The accuracy of 3.0T TOF - MRA to evaluate the patency of the parent artery was low, we may obtain better image by optimizing the sequence parameters.