在缺血性脑血管疾病诊断中pCASL、3D-TOF-MRA与DSA的比较

Comparison of pC ASL,3D-TOF-MRA and DSA in the diagnosis of ischemic cerebrovascular diseases

目的探讨缺血性脑血管疾病诊断中p CASL、3D-TOF-MRA与DSA的比较价值。方法将我院神经外科考虑缺血性脑血管病的98例患者作为研究对象,采用3.0T磁共振成像系统分别进行p CASL检查、3D-TOF-MRA检查,p CASL+3D-TOF-MRA检查,采用DSA进行血管造影,以观察和比较4种方法对缺血性脑血管病患者颅内动脉狭窄判断的一致性。结果以DSA为对照,p CASL准确度为89.8%,特异性为77.55%,灵敏度为90.82%,2种方法比较,无显著差异(P>0.05=0.180),2种方法吻合度一般(κ=0.553,P<0.05)。3D-TOF-MRA准确度为83.67%,特异性为55.1%,灵敏度为87.76%,比较2种方法,无显著差异(P>0.05=0.180),2种方法吻合度较弱(κ=0.331,P<0.05)。MRA+p CASL检出颅内动脉狭窄准确度为91.84%,特异性为87.5%,灵敏度为93.33%,比较2种方法,无显著差异(P>0.05=0.180),2种方法吻合度较好(κ=0.752,P<0.05)。结论在3D-TOF-MRA的基础上,加扫p CASL进行观察判断,高阳性发现得到提高,在临床上3D-TOF-MRA+p CASL联合使用值得推广。

Objective To compare the value of pCASL, 3D-TOF-MRA and DSA in the diagnosis of ischemic cerebrovascular diseases. Methods From June 2016 to June 2017 in the Department of neurosurgery in our hospital, 98 patients with ischemic cerebrovascular disease patients were taken as the research object, pCASL was performed using 3.0 T magnetic resonance imaging system 3 D-TOF-MRA examination, pCASL ＋ 3D-TOF-MRA examination. Using DSA angiography, we observed and compared the 4 methods to determine the consistency of ischemic cerebrovascular disease patients with intracranial artery stenosis. Results With DSA as the control, the accuracy of pCASL was 89.8% , the specificity was 77.55% , the sensitivity was 90.82%. There was no significant difference between the 2 methods （ P 〉0.05 =0. 180）, and the 2 methods had the same degree of agreement （ K =0. 553, P 〈 0.05）. 3D-TOF-MRA accuracy was 83.67%, specificity was 55.1% , sensitivity was 87.76% , compared with the 2 methods, there was no significant difference （ P 〉0.05 =0. 180）, and the 2 methods were less consistent （ K = O. 331, P 〈 0.05 ）. MRA ＋ pCASL in the detection of intracranial artery stenosis and accuracy was 91.84%, the specificity was 87.5%, sensitivity was 93.33% , compared with 2 methods, there was no significant difference （ P 〉0.05 =0. 180）, 2 kinds of methods were in good agreement （ K = 0. 752, P 〈 0.05）. Conclusion On the basis of 3D-TOF-MRA, plus pCASL scan for observation and judgment, high positive findings have been improved, in clinical, 3D-TOF-MRA ＋ pCASL combined use is worth promoting.