磁共振血管成像与三维动脉自旋标记脑灌注成像技术诊断缺血性脑血管疾病一致性比较

Comparison of consistency of MRA and 3D-ASL cerebral perfusion imaging in the diagnosis of ischemic cerebrovascular diseases

目的探讨磁共振血管成像(MRA)、三维动脉自旋标记(3D-ASL)脑灌注成像技术诊断缺血性脑血管疾病的一致性。方法我院收治的考虑缺血性脑血管疾病患者120例,均通过MRA、3D-ASL脑灌注成像技术检查,以数字减影血管造影(DSA)作为金标准,比较MRA成像与3D-ASL诊断结果与金标准的一致性。结果3D-ASL诊断冠状动脉狭窄与金标准一致性Kappa=0.794高于MRA诊断Kappa=0.462(P<0.05);3D-ASL诊断正常类型、短暂性脑缺血、小面积脑梗死与金标准一致性Kappa值分别为0.838,0.767,0.868高于MRA诊断Kappa值0.541,0.563,0.642(P<0.05);两种检测方法检测大面积脑梗死与金标准一致性比较差异无统计学意义(P>0.05)。结论3D-ASL诊断冠状动脉狭窄与缺血性脑血管疾病类型诊断一致性高于MRA。

Objective To investigate the consistency of magnetic resonance angiography( MRA) and three-dimensional arterial spin labeling( 3D-ASL) cerebral perfusion imaging in the diagnosis of ischemic cerebrovascular diseases.Methods A total of120 patients with ischemic cerebrovascular diseases in our hospital were selected.All patients were given examinations of both MRA imaging and 3D-ASL cerebral perfusion imaging. When digital substraction angiography( DSA) by digital substraction angiography machine was used as the gold standard,the consistency of MRA imaging and 3D-ASL diagnostic results was compared. Results The consistency of 3D-ASL and gold standard in the diagnosis of coronary artery stenosis( Kappa = 0. 794) was higher than MRA diagnosis( Kappa= 0. 462;P < 0. 05).The Kappa values of 3D-ASL and the gold standard in the diagnosis of normal types,transient cerebral ischemia and small-area cerebral infarction were 0. 838,0. 767 and 0. 868,respectively,which were higher than the Kappa values of0. 541,0. 563 and 0. 642 of MRA( P < 0. 05).There was no significant difference in the consistency of the two methods and gold standard in the detection of large-area cerebral infarction( P > 0. 05).Conclusion 3D-ASL has higher consistency than MRA in the diagnosis of coronary artery stenosis and ischemic cerebrovascular diseases.