颅内动脉狭窄与闭塞诊断中MR增强血管成像的应用价值研究

The Value of MR Enhanced Angiography in the Diagnosis of Intracranial Artery Stenosis and Occlusion

目的:探讨颅内动脉狭窄与闭塞诊断中MR增强血管成像的应用价值。方法:选取2017年1月-2019年1月我院收治的颅内动脉狭窄与闭塞患者128例,将DSA检查作为金标准,分别行数字减影血管造影(DSA)及MRI检查,比较两种诊断方法诊断价值。结果:128例患者,共检出283条正常血管,69条颅内动脉闭塞、狭窄血管,DSA检出276条正常血管,76条颅内动脉闭塞、狭窄血管。将DSA诊断结果作为金标准,MRI检查脑梗死患者血管闭塞、狭窄特异度、阴性预测值、灵敏度、阳性预测值分别为92.2%、94.4%、77.7%、71.1%,漏诊率、误诊率分别为29.0%、5.6%;128例患者中MRI检查发现,3条BA狭窄血管,4条TICA狭窄血管,8条VA狭窄血管。DSA检查发现3条BA狭窄血管,5条TICA狭窄血管,9条VA狭窄血管;MRI诊断发现10条ACA狭窄血管,23条MCA狭窄血管,8条PCA狭窄血管。DSA检查发现,8条PCA狭窄血管,11条ACA狭窄血管,23条MCA狭窄血管。结论:MRI可对颅内动脉狭窄与闭塞有效诊断,具有较高灵敏度和特异度,同时可降低漏诊及误诊发生率,具有非常高的临床应用价值。因此,在颅内动脉狭窄与闭塞患者临床诊断中,值得进一步推广和应用。

Objective:To evaluate the value of MR enhanced angiography in the diagnosis of intracranial artery stenosis and occlusion.Methods:from January 2017 to January 2019,128 patients with intracranial artery stenosis and occlusion were enrolled in our hospital.DSA was taken as the gold standard,and DSA and MRI were performed respectively to compare the diagnostic value of the two methods.Results:in 128 patients,283 normal blood vessels were detected,69 intracranial artery occlusion and stenosis,276 normal blood vessels and 76 intracranial artery occlusion and stenosis were detected by DSA.The DSA diagnostic results were taken as the gold standard.The MRI findings of occlusion,stenosis specificity,negative predictive value,sensitivity and positive predictive value were 92.2%,94.4%,77.7%and 71.1%respectively.The missed diagnosis rate and misdiagnosis rate were 29.0%and 5.6%respectively.MRI findings of 128 patients showed that there were 3 Ba stenosis vessels,4 TICA stenosis vessels and 8 VA stenosis vessels.DSA showed 3 Ba stenosis,5 TICA stenosis and 9 VA stenosis;MRI showed 10 ACA stenosis,23 MCA stenosis and 8 PCA stenosis.DSA showed that there were 8 PCA stenosis,11 ACA stenosis and 23 MCA stenosis.Conclusion:MRI can effectively diagnose intracranial artery stenosis and occlusion with high sensitivity and specificity,and reduce the incidence of missed diagnosis and misdiagnosis.Therefore,in the clinical diagnosis of intracranial artery stenosis and occlusion,it is worth further promotion and application.