CT血管造影和MRI在脊髓血管畸形术后随诊中的价值

The Value of CT Angiography and MRI in the Postoperative Follow-Up of Spinal Cord Vascular Malformations

目的探讨CT血管造影和MRI在脊髓血管畸形术后随诊中的应用价值。方法155例脊髓血管畸形术后复查的患者全部完成选择性全脊柱动脉造影检查,由经过统一培训的3名放射科医生对其中80例完成CTA和126例完成MRI检查的患者进行回顾性分析,对照选择性全脊柱动脉造影的检查结果,评价CTA和MRI这2种检查方法的灵敏度和特异度,并对这2种方法串联后的结果进行评价。结果CTA的灵敏度为90.2%,特异度为84.6%,假阳性率为9.8%,假阴性率为15.4%。MRI的灵敏度为90.1%,特异度为65.5%,假阳性率为9.9%,假阴性率为34.5%。脊髓CTA和MRI的串联诊断结果灵敏度为70.3%,特异度为98.1%,假阳性率为29.7%,假阴性率为1.9%。结论脊髓CTA和MRI的串联诊断具有较高的特异度和较好的灵敏度,在脊髓血管畸形患者术后的随诊中联合应用可以使假阳性率降到最低,具有较高的临床应用价值。

Objective To investigate the value of CT angiography and MRI in the postoperative follow-up of spinal cord vascular malformations.Methods A total of 155 patients with spinal cord vascular malformations underwent selective whole-spine arterial angiography.Three trained radiologists evaluated and compared the sensitivity and specificity of the CTA,MRI,and CTA tandem MRI methods by retrospective analyzing the results of 80 patients who underwent CTA and 126 patients underwent MRI.Results The sensitivity,specificity,false negative rate and false positive rate of CTA were 90.2%,84.6%,9.8%and 15.4%,respectively.In contrast,the sensitivity,specificity,false negative rate and false positive rate of MRI were 90.1%,65.5%,9.9%and 34.5%.The diagnostic performance of spinal CTA tandem MRI approach showed a sensitivity of 70.3%,a specificity of 98.1%,a false negative rate of 29.7%and a false positive rate of 1.9%.Conclusion The tandem diagnosis approach of spinal cord CTA and MRI has lower sensitivity and better specificity,which is of great value in the follow-up of patients with spinal vascular malformation after surgery.