3D-CUBE T1高分辨率磁共振序列在颅脑动脉血栓诊断中的应用

Application of 3D-CUBE T1 High-Resolution Magnetic Resonance Imaging in Diagnosis of Cerebral Arterial Thrombosis

目的评价3D-CUBE T1序列在脑梗死患者颅脑动脉血栓诊断中的临床应用价值。方法前瞻性纳入2017年3月至2018年9月69例脑梗死患者(发病时间8 h^14天,其中男38例,女31例,年龄33~78岁),均行颅脑扩散加权成像(DWI)、磁敏感加权成像(SWI)、3D-CUBE T1高分辨率磁共振序列扫描。以数字减影血管造影(DSA)为诊断颅脑动脉血栓的参考标准。由DWI图像确定责任血管的大体位置,两位高年资神经影像医师分别将3D-CUBE T1和SWI的诊断结果与DSA对照,通过计算敏感度、特异度、阳性预测值、阴性预测值及受试者工作特征(ROC)曲线下面积(AUC),比较3D-CUBE T1序列与SWI磁敏感血管征(SVS)对责任血管血栓显示的诊断价值的大小,采用Kappa检验来衡量3D-CUBE T1序列与DSA的一致性。结果在69例患者中,以DSA为依据诊断颅脑动脉血栓的患者共45例,其中3D-CUBE T1序列与SWI显示的阳性患者分别为45例、34例,3D-CUBE T1序列及SWI诊断颅脑动脉血栓的敏感度分别为100%和75.6%,应用3D-CUBE T1序列的AUC值大于应用SWI(0.958 vs0.857,P<0.05),3D-CUBE T1序列与DSA在动脉血栓的显示方面具有优秀的一致性(Kappa值为0.934,P<0.05)。结论3D-CUBE T1高分辨率磁共振序列能够直观地显示颅脑动脉内血栓的分布情况及信号差异,对于脑梗死患者颅脑动脉血栓的诊断具有较高的临床应用价值。

Objective To evaluate the clinical value of 3D-CUBE T1 sequence in the diagnosis of cerebral artery thrombosis in patients with cerebral infarction.Methods From March 2017 to September 2018,69 patients with cerebral infarction(the onset time ranged from 8h to 14d,including 38 males and 31 females,aged 33 to 78 years)were prospec-tively enrolled.All patients underwent diffusion weighted imaging(DWI),magnetic susceptibility weighted imaging(SWI)and 3D-CUBE T1 high-resolution MRI sequence.The diagnostic criteria of cerebral artery thrombosis weredigital subtraction angiography(DSA).The gross location of the responsible vessels was determined by DWI images.The diagnostic results of 3D-CUBE T1 sequence and SWI were compared with the reference standard by two senior neuroimaging physi-cians.Comparing the diagnostic value of 3D-CUBE T1 sequence and SWI susceptibility vessel sign(SVS)to the display of craniocerebral arterial thrombosis in responsible vessels by calculating sensitivity,specificity,positive predictive value,negative predictive value and area under ROC curve(AUC).Kappa test was used to measure the consistency of 3D-CUBE T1 sequence and reference standard.Results In 69 patients,a total of 45 patients were diagnosed with craniocerebral ar-terial thrombosis according to the reference standard.The sensitivity of 3D-CUBE T1 and SWI was 100%and 75.6%,re-spectively.The AUC value of 3D-CUBE T1 was higher than that of SWI(0.958 vs 0.857,P<0.05).The 3D-CUBE T1 sequence was in great agreement with the reference standard in the diagnosis of cerebral artery thrombosis.(Kappa=0.934,P<0.05).Conclusion 3D-CUBE T1 high resolution magnetic resonance sequence can directly display the distri-bution and signal difference of intracranial arterial thrombosis,and has a high clinical value for the diagnosis of cerebralar-terial thrombosis in patients with cerebral infarction.