高分辨磁共振成像对大脑中动脉狭窄性病变的诊断价值

The Diagnostic Value of High-resolution Magnetic Resonance Imaging for Middle Cerebral Artery Stenosis

目的探讨高分辨磁共振成像(HRMRI)对大脑中动脉(MCA)狭窄性病变的诊断价值。方法回顾性分析2015年8月~2019年8月我院52例确诊为MCA狭窄性病变患者的影像学资料,分别行HRMRI及DSA诊断,分析两种诊断方式下大脑中动脉狭窄性病变诊断情况、大脑中动脉狭窄性病符合情况、住院时间、住院费用及斑块形态诊断。结果52例MCA狭窄性病变患者中共有104段大脑中动脉MI段,行HRMRI及DSA诊断患者中血管正常患者50例,轻度狭窄血管、中度狭窄血管、重度狭窄血管及闭塞血管分别有7段、19段、20段、5段;对104段大脑中动脉MI段行HRMRI及DSA诊断,结果相同的有101段,诊断符合率占97.12%;诊断偏高1段,占0.10%;诊断偏低2段,占1.92%;HRMRI诊断结果符合率低于DSA,但差异无统计学意义(P>0.05);HRMRI诊断患者住院时间短于DSA,治疗费用低于DSA,差异有统计学意义(P<0.05);HRMRI诊断斑块形态及斑块类型诊断结果优于DSA,差异有统计学意义(P<0.05)。结论以DSA为诊断MCA狭窄性病变金标准,HRMRI诊断准确性较高且能够清晰显示动脉壁及粥样硬化斑块的病理变化,具有较高的临床应用价值。

Objective To investigate the diagnostic value of high-resolution magnetic resonance imaging(HRMRI)for middle cerebral artery(MCA)stenosis.Methods A retrospective analysis of the imaging data of 52 patients with MCA stenosis in our hospital from August 2015 to August 2019.HRMRI and DSA were performed respectively to analyze the diagnosis of middle cerebral artery stenosis lesions,the compliance of middle cerebral artery stenosis and venereal diseases,the length of stay,the cost of hospitalization and the diagnosis of plaque morphology under the two diagnostic methods.Results There were 104 middle cerebral artery MI segments in 52 patients with MCA stenosis.50 patients with normal blood vessels were diagnosed by HRMRI and DSA.There are 7 segments,19 segments,20 segments,and 5 segments for mildly stenotic blood vessels,moderately stenotic blood vessels,severely stenotic blood vessels,and occluded blood vessels;HRMRI and DSA were performed on 104 MI segments of the middle cerebral artery,101 segments had the same result,and the diagnosis coincidence rate accounted for 97.12%;The diagnosis was high in 1 segment,accounting for 0.10%;the diagnosis was low in 2 segments,accounting for 1.92%;the coincidence rate of HRMRI diagnosis results was lower than that of DSA,but the difference was not statistically significant(P>0.05);The hospitalization time of patients diagnosed by HRMRI was shorter than that of DSA,and the treatment cost was lower than that of DSA,the difference was statistically significant(P<0.05);HRMRI was superior to DSA in diagnosing plaque shape and plaque type,the difference was statistically significant(P<0.05).Conclusion With DSA as the gold standard for diagnosing MCA stenosis lesions,HRMRI has high diagnostic accuracy and can clearly show the pathological changes of arterial wall and atherosclerotic plaque,which has high clinical application value.