MRI 3D T2-SPACE诊断大脑中动脉及基底动脉狭窄的价值

Value of MRI 3D T2-SPACE in the Diagnosis of Middle Cerebral Artery and Basilar Artery Stenosis

目的评价MRI 3D T2-SPACE诊断大脑中动脉及基底动脉狭窄的价值。方法选取2019年11月至2020年10月在南京医科大学附属淮安第一医院就诊的40例脑血管狭窄患者为研究对象,选取符合研究要求的大脑中动脉及基底动脉共120根。在入院1周内完成颅颈动脉MRI 3D T2-SPACE和数字减影血管造影(DSA)检查,分别评估动脉狭窄程度。按狭窄程度分成轻度(1%~49%)、中度(50%~69%)、重度(70%~99%)和闭塞(100%),和金标准DSA检查对照,计算灵敏度、特异度,并分析MRI 3D T2-SPACE和DSA诊断结果的一致性。结果MRI 3D T2-SPACE诊断大脑中动脉及基底动脉狭窄/闭塞的灵敏度、特异度结果如下,轻度狭窄分别为90.0%、96.4%,中度狭窄分别为77.8%、98.2%,重度狭窄分别为96.7%、97.8%,闭塞分别为87.5%、100.0%。MRI 3D T2-SPACE与DSA检查诊断大脑中动脉及基底动脉轻、中、重度狭窄及闭塞的一致性分别为0.760、0.760、0.934、0.929。结论MRI 3D T2-SPACE能够较准确地评估大脑中动脉及基底动脉狭窄程度,特别是对重度狭窄及闭塞的诊断与DSA检查结果高度一致,作为血管检查的一种全新技术,其将会在临床发挥重要作用。

Objective To evaluate the value of MRI 3D T2-SPACE sequence in the diagnosis of middle cerebral artery and basilar artery stenosis.Methods A total of 40 patients with ischemic stroke that admitted to the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University from November 2019 to October 2020 were collected and a total of 120 middle cerebral artery and basilar artery that met research requirements were selected.MRI 3D T2-SPACE and DSA were performed within one week after admission to assess the degree of arterial stenosis.According to the degree of stenosis,the patients were divided into mild(1%-49%),moderate(50%-69%),severe(70%-99%)and occlusion(100%).The specificity,sensitivity were calculated,and consistency of MRI 3D T2-SPACE and DSA diagnosis results were analyzed and evaluated.Results The sensitivity,specificity of MRI 3D T2-SPACE were 90.0%,96.4%for mild stenosis,77.8%,98.2%for moderate stenosis,96.7%,97.8%for severe stenosis and 87.5%,100.0%for occlusion,respectively.The consistency of MRI 3D T2-SPACE and DSA in judging mild,moderate,severe and occlusion of middle cerebral artery and basilar artery stensis were 0.760,0.760,0.934 and 0.929,respectively.Conclusion MRI 3D T2-SPACE can more accurately assess the degree of stenosis of the middle cerebral artery and basilar artery,especially the diagnosis of severe stenosis and occlusion is highly consistent with the results of DSA examination.As a new technique for vascular examination,it will play an important role in clinical practice.