高分辨率磁共振血管成像对颅内动脉狭窄及闭塞的诊断价值

Value of high-resolution magnetic resonance angiography in diagnosis of intracranial artery stenosis and occlusion

目的:探讨高分辨率磁共振血管成像(HR-MRI)对颅内动脉狭窄及闭塞的诊断价值。方法:抽取2017年3月至2020年6月临汾市中心医院收治的脑梗死患者97例,经数字减影血管造影(DSA)诊断为颅内动脉狭窄或闭塞,并行HR-MRI检查。以DSA检查结果为金标准,回顾性统计HR-MRI的诊断效能,应用Kappa行一致性分析(K≥0.75为一致性较好)。结果:97例患者共筛查血管1012条,其中DSA检出狭窄或闭塞颅内动脉228条,HR-MRI检出215条,HR-MRI诊断敏感率为71.05%(162/228),诊断特异度为93.24%(731/784),诊断符合率为88.24%(893/1012)。HR-MRI对大脑后动脉、大脑中动脉、大脑前动脉、颈内动脉终末段、椎动脉、基底动脉狭窄检出结果与DSA的一致性,K=0.961、0.972、0.825、0.797、0.954、1.000。结论:高分辨率磁共振技术是一种有效的脑内动脉壁成像技术,可有效对患者脑内动脉的狭窄、闭塞情况进行判断,与DSA诊断结果具有较好的一致性,可作为DSA的补充检查。

Objective To investigate the value of high-resolution magnetic resonance angiography(HR-MRI)in the diagnosis of intracranial artery stenosis and occlusion.Methods A selection of 97 patients with cerebral infarction admitted to Linfen Central Hospital from March 2017 to June 2020,all diagnosed as intracranial artery stenosis or occlusion through digital subtraction angiography(DSA)examination,and all were performed HR-MRI examination.The DSA examination results were taken as gold standard to count the diagnostic efficacy of HR-MRI for intracranial artery stenosis and occlusion,and the consistency analysis was performed using Kappa(K≥0.75 mean better consistency).Results A total of 1012 blood vessels were screened in 97 patients,of which DSA detected stenosis or occlusion of intracranial arteries 228,and HR-MRI detected 215.The diagnostic sensitivity rate of HR-MRI was 71.05%(162/228),the diagnostic specificity was 93.24%(731/784),and the diagnostic coincidence rate was 88.24%(893/1012).The results of HR-MRI in the detection of posterior cerebral artery,middle cerebral artery,anterior cerebral artery,terminal internal carotid artery,vertebral artery,and basilar artery stenosis were consistent with DSA.K=0.961,0.972,0.825,0.797,0.954,1.000.Conclusions High-resolution magnetic resonance technology is an effective intracerebral artery wall imaging technique,which can effectively judge the stenosis and occlusion of the patient’s intracerebral arteries.It has good consistency with the diagnosis of DSA and can be used as a supplementary examination of DSA.