三维完美采样可变翻转角优化对比序列检测下肢深静脉血栓的诊断价值

The diagnostic value of 3-dimensional SPACE sequence in detecting deep vein thrombosis of the lower extremity

目的:评估非对比剂增强磁共振三维完美采样可变翻转角优化对比序列(SPACE)检测下肢深静脉血栓的诊断价值。方法:94例疑似有下肢深静脉血栓(DVT)的患者做下肢血管超声检查和SPACE检查。以超声作为金标准,分别在静脉节段水平、单侧肢体水平和患者水平,计算SPACE检测深静脉血栓(DVT)的敏感度和特异度。通过计算Cohen kappa系数来评定SPACE评估DVT状态(不存在,不全闭塞,完全闭塞)的观察者间一致性。结果:SPACE检测DVT的敏感度/特异度为96.53%/99.90%(节段水平),95.24%/99.04%(单侧肢体水平),95.89%/95.24%(患者水平)。SAPCE评估血栓状态的观察者间一致性好(Kappa=0.894±0.020,P=0.000)。结论:非对比剂增强磁共振三维SPACE检测下肢深静脉血栓准确性高。对于那些不能做超声检查的患者,SPACE可以作为替代检查。

Objectives:To evaluate the diagnostic performance of non-contrast enhanced magnetic resonance imaging utilizing sampling perfection with application optimized contrasts using different flip angle evolutions(SPACE)in the diagnosis of detecting deep venous thrombus(DVT)of the lower extremity.Methods:Ninety-four consecutive patients suspected of lower extremity DVT underwent ultrasound(US)and SPACE.The sensitivity and specificity of SPACE in detecting DVT were calculated based on segment,limb,and patient,with US serving as the reference standard.Cohen kappa coefficients were calculated to assess the inter-observer consistency of SPACE in evaluating DVT status(absent,incomplete occlusion,complete occlusion).Results:The sensitivity/specificity of SPACE to detect DVT is 96.53%/99.90%(segment),95.24%/99.04%(limb),and 95.89%/95.24%(patient).Interobserver agreement of SPACE in assessing thrombosis was excellent(kappa=0.894±0.020,P=0.000).Conclusion:High accuracy of non contrast enhanced three-dimensional SPACE in detecting deep vein thrombosis of lower extremities.SPACE could serve as an important alternative for patients in whom US cannot be performed.For those who can not do ultrasound examination,SPACE can be used as an alternative inspection.