MRA联合3D-ASL检查在缺血性脑血管疾病诊断中的价值

Value of MRA combined with 3D-ASL in diagnosis ischemic cerebrovascular disease

目的:分析缺血性脑血管疾病应用磁共振血管成像(MRA)联合三维动脉自旋标记技术(3D-ASL)检查进行诊断的价值。方法:选取2018年2月~2019年11月我院收治的41例缺血性脑血管疾病患者作为病例组,并选取同期51例非缺血性脑血管疾病患者为对照组,均接受MRA、3D-ASL检查,统计MRA、3D-ASL、MRA联合3D-ASL检出缺血性脑血管疾病情况,并以临床诊断结果为准,比较MRA、3D-ASL、MRA联合3D-ASL诊断缺血性脑血管疾病灵敏度、准确度、特异度。结果:MRA检出缺血性脑血管疾病33例,非缺血性脑血管疾病59例;3D-ASL检出缺血性脑血管疾病33例,非缺血性脑血管疾病59例;MRA联合3D-ASL检出缺血性脑血管疾病41例,非缺血性脑血管疾病51例;MRA联合3D-ASL诊断缺血性脑血管疾病灵敏度、准确度(97.56%、97.83%)高于单一MRA(75.61%、86.96%)、3D-ASL(73.17%、84.78%)(P<0.05);MRA、3D-ASL、MRA联合3D-ASL诊断缺血性脑血管疾病特异度(96.08%、94.12%、98.04%)比较差异无统计学意义(P>0.05)。结论:MRA联合3D-ASL检查应用于缺血性脑血管疾病患者,不仅可评价脑血管,亦可评价脑灌注变化,互相弥补,提高诊断灵敏度、准确度。

Objective:To determine the diagnostic value of magnetic resonance angiography(MRA)combined with three-dimensional arterial spin labeling(3D-ASL)in ischemic cerebrovascular disease(ICD).Methods:Forty-one ICD patients treated in our hospital between February 2018 and November 2019 were enrolled as the case group,and a contemporary cohort of 51 non-ICD patients were enrolled as the control group.All subjects underwent MRA and 3D-ASL.The diagnosis of ICD by MRA,3D-ASL,and MRA combined with 3D-ASL was recorded.Based on the final clinical diagnosis,the sensitivity,accuracy,and specificity of MRA,3D-ASL,and MRA combined with 3D-ASL in diagnosing ICD were compared.Results:MRA detected 33 cases of ICD and 59 of non-ICD;3D-ASL,33 cases of ICD and 59 of non-ICD;MRA combined with 3D-ASL,41 cases of ICD and 51 of non-ICD.The sensitivity and accuracy of MRA combined with 3D-ASL in diagnosing ICD(97.56%,97.83%)were higher than those with MRA(75.61%,86.96%)or 3D-ASL(73.17%,84.78%)alone(P<0.05).The specificity did not vary significantly among MRA,3D-ASL and MRA combined with 3D-ASL(96.08%,94.12% and 98.04%,respectively)in the ICD diagnosis(P>0.05).Conclusion:For diagnosis of ICD,MRA combined with 3D-ASL may be useful to evaluate the cerebrovascular conditions as well as the cerebral perfusion changes.The combining the both can be complementary and result in better diagnostic sensitivity and accuracy.