3.0T三维时间飞跃法磁共振血管造影在颅内动脉瘤诊断中的应用

Application of 3.0T 3D-TOF-MRA in the diagnosis of intracranial aneurysm

目的:探究3.0T三维时间飞跃(3D-TOF)法磁共振血管造影(MRA)在颅内动脉瘤诊断中的应用价值。方法:前瞻性选择收治的79例疑似颅内动脉瘤患者,对其均行3D-TOF-MRA检查,两周内行三维数字减影血管造影(3D-DSA)检查,以3D-DSA诊断结果作为金标准,分析3D-TOF-MRA对患者动脉瘤的诊断价值。结果:79例患者经3D-DSA检查共检出77枚颅内动脉瘤,9例患者未检出动脉瘤;3D-TOF-MRA检查共检出83枚动脉瘤,6例患者未检出动脉瘤;3D-TOF-MRA正确诊断动脉瘤75枚,诊断准确率为90.36%(75/83),其中6枚动脉瘤为假阳性,2枚动脉瘤未被检出。3D-TOF-MRA正确诊断患者73例,对患者诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为97.14%、55.56%、92.40%、94.44%和71.43%,与3D-DSA诊断的Kappa一致性为0.583。结论:3D-TOF-MRA在颅内动脉瘤诊断中具有较高诊断效能,临床应用时应注意在微小动脉瘤的诊断。

Objective:To explore the application value of 3.0T three-dimensional time of flight magnetic resonance angiography(3D-TOF-MRA)in the diagnosis of intracranial aneurysm.Methods:A total of 79 patients with suspected intracranial aneurysms who admitted to the department of radiology were prospective enrolled.All patients underwent 3D-TOF-MRA examination.And 3D digital subtraction angiography(3D-DSA)examination was performed on them within 2 weeks since 3D-TOF-MRA examination.Taking diagnostic results of 3D-DSA as golden standard,the diagnostic value of 3D-TOF-MRA for aneurysms of patients was analyzed.Results:A total of 77 intracranial aneurysms were confirmed by 3D-DSA in 79 patients,and there was no aneurysm was found in 9 patients as this method.83 aneurysms were found by 3D-TOF-MRA examination,and there was no aneurysm was found in 6 patients as this method.In terms of evaluation for aneurysm,75 aneurysms were correctly diagnosed by 3D-TOF-MRA,with diagnostic accuracy of 90.36%(75/83).Among them,there were 6 false positive aneurysms,and 2 aneurysms not were checked out.In terms of evaluation for patients,73 patients were correctly diagnosed by 3D-TOF-MRA,and the diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy for patients were 97.14%,55.56%,92.40%,94.44%and 71.43%,respectively.The Kappa value of consistency between 3D-TOF-MRA and 3D-DSA was 0.583.Conclusion:The diagnostic efficiency of 3D-TOF-MRA is relatively higher for the diagnosis of intracranial aneurysms.And in the clinical application,the diagnosis for microaneurysms should be paid attention to.