高分辨率磁共振和CT在颅脑动脉血栓诊断中的应用

Application of High-Resolution Magnetic Resonance and CT in the Diagnosis of Craniocerebral Artery Thrombosis

目的 观察高分辨磁共振成像(HR-MRI)和计算机断层扫描(CT)在颅脑动脉血栓中的诊断价值。方法 例单侧脑梗死患者为研究对象(发病时间8h~14d,男61例,女33例,年龄38~75岁)。所有患者均行HR-MRI[磁敏感加权成像(SWI)、Cube液体衰减反转恢复序列(FLAIR)]和128层螺旋CT检查,以数字减影血管造影(DSA)检查结果为金标准,分析HR-MRI和CT检查对颅脑动脉血栓的诊断价值。结果94例患者中,共有50例患者DSA明确诊断为动脉血栓,包括ICA颅内段5例、ACA 3例、MCA 26例、PCA 2例、VA 11例、BA 3例。HR-MRI共检出48例(SWI检出40例,Cube FLAIR检出43例),CT共检出38例。以DSA检查为“金标准”,HR-MRI和CT诊断颅脑血栓的灵敏度为96.00% vs 70.00%,特异度为100.00% vs 93.18%,准确度为95.83% vs 80.85% ,Kappa值为0.945 vs 0.516。结论 HR-MRI与CT在颅脑动脉血栓中均有较高的诊断价值,但HR-MRISWI及Cube FLAIR对颅脑动脉血栓的诊断价值更高。

Objective To observe the diagnostic value of high-resolution magnetic resonance imaging(HR-MRI)and computed tomography(CT)in craniocerebral artery thrombosis.Methods Ninety-four patients with unilateral cerebral infarction admitted to our hospital from December 2019 to November 2021were selected as the research subjects(onset time was 8 hours to 14 days,61 males and 33 females,age 38-75 years old).All patients underwent HR-MRI[susceptibility weighted imaging(SWI),Cube fluid attenuated inversion recovery(FLAIR)]and 128-slice spiral CT.The results of digital subtraction angiography(DSA)were used as the gold standard.Analysis The diagnostic value of HR-MRI and CT in craniocerebral artery thrombosis.Results A total of 50 patients with DSA in 94 patients were clearly diagnosed as arterial thrombosis,including 5 cases of ICA intracranial segment,3 cases of ACA,26cases of MCA,2 cases of PCA,11 cases of VA,and 3 cases of BA.A total of 48 cases were detected by HR-MRI(40 cases by SWI and 43 cases by Cube FLAIR),and a total of 38 cases were detected by CT.Taking DSA examination as the gold standard,the sensitivity of HR-MRI and CT in diagnosing craniocerebral thrombosis is 96.00%vs.70.00%,the specificity is 100.00%vs.93.18%,the accuracy is 95.83%vs.80.85%,and the Kappa value is 0.945 vs.0.516.Conclusion HR-MRI and CT have higher diagnostic value in craniocerebral artery thrombosis,but HR-MRI SWI and Cube FLAIR have higher diagnostic value in craniocerebral artery thrombosis.