3D IVWI与DSA评价颅内动脉粥样硬化狭窄对比研究

3D IVWI Versus DSA in Evaluating Atherosclerotic Stenosis of Intracranial Artery:A Comparative Study

目的:通过与数字减影血管造影(DSA)对比,探讨三维磁共振颅内血管壁成像(3D IVWI)诊断颅内动脉粥样硬化性狭窄的临床价值。方法:收集42例颅内动脉粥样硬化患者,在3D IVWI和DSA上分别测量管腔狭窄程度及斑块长度;并评价3D IVWI和DSA测量结果的一致性和相关性。结果:42例患者共检出102个颅内动脉粥样硬化斑块。Bland-Altman分析图显示2种检查手段测量管腔狭窄程度和斑块长度具有较好的一致性,组内相关系数(ICC)均大于0.77(分别为0.84和0.85)。在测量管腔狭窄程度(r=0.69,P<0.001)和斑块长度(r=0.84,P<0.001)上,3D IVWI与DSA存在相关性。3D IVWI测量的斑块长度较DSA长(P<0.001)。结论:与DSA相比,3D IVWI对颅内动脉粥样硬化性狭窄诊断准确,重复性好,能检测到更多的斑块,在颅内动脉粥样硬化斑块检测、诊断及治疗中有较高的价值。

Purpose:To evaluate the clinical value of three-dimensional magnetic resonance intracranial vessel wall imaging(3 D IVWI)in assessing the degree of intracranial atherosclerotic stenosis compared to digital subtraction angiography(DSA).Methods:A total of 42 patients with intracranial atherosclerotic disease were enrolled in this study.Luminal stenosis and lesion length were measured on both DSA and 3 D IVWI.Bland-Altman analysis and Spearman correlation analysis were used to evaluate the consistency and correlation between 3 D IVWI and DSA.Results:Forty-two symptomatic patients with 102 intracranial atherosclerotic plaques were included in the final analysis.Good agreement in measuring stenosis and lesion length was found between 3 D IVWI and DSA,and the intra-class correlation coefficient(ICC)was 0.84 and 0.85,respectively(all ICCs>0.77).There was correlation between 3 D IVWI and DSA in measuring stenosis(Spearman r=0.69,P<0.001)and in lesion length(Spearman r=0.84,P<0.001).However,lesion length measurements by using 3 D IVWI were longer than those measured by usingDSA(P<0.001).Conclusion:3 D IVWI is accurate and reproduceable for quantifying intracranial artery stenosis comparing with DSA,and with high value in the detection,diagnosis and treatment of intracranial atherosclerotic plaque.