3D-TOF-MRA对椎-基底动脉病变的诊断价值

Value of 3.0T High-field Ma gnetic Resonance 3D-TOF-MRA on the Identification of Intracranial Vertebral-Basilar Lesions

目的 探讨磁共振三维时间飞跃动脉血管成像(3D-TOF-MRA)对颅内椎-基底动脉病变的诊断价值。方法 从2019.1至2021.12期间因头痛、眩晕、肢体麻木等症状入院的240例中,其中确诊为颅内椎-基底动脉病变的95例为疾病组(病变组),145例均为非颅内椎-基底动脉病变(非病变组)。240例同时都有3T 3D-TOF-MRA和DSA检查完整资料。采用Kappa一致性检验对比两种方法对椎动脉、基底动脉血管异常类型的一致性,最后评价3D-TOF-MRA与对颅内椎-基底动脉病变的诊断价值。结果 3D-TOF-MRA与DSA评估椎动脉、基底动脉血管异常类型的一致性检验Kappa值分别为0.874、0.862;对照DSA“金标准”3D-TOF-MRA诊断颅内椎-基底动脉病变的灵敏度、特异度准确度分别为94.74%、92.41%、93.33%。结论 3D-TOF-MRA可以清楚显示颅内椎-基底动脉及主要分支的狭窄、闭塞动脉瘤、夹层等异常,具有等同DSA的诊断价值,与DSA有良好的一致性。

Objective To explore the value of 3.0T high-field magnetic resonance three-dimensional time of flight magnetic resonance angiography(3D-TOF-MRA)on the identification of intracranial vertebral-basilar lesions.Methods The clinical data of 240 patients admitted to hospital due to headache,dizziness,limb numbness and other symptoms were retrospectively analyzed between January 2019 and December 2021,including 95 patients with intracranial vertebral-basilar lesions(enrolled in the lesion group)and 145 patients withn on-intracranial vertebral-basilar lesions(selected as the non-lesion group).Kappa consistency test was used to evaluate the consistency of 3.0T high-field magnetic resonance 3D-TOFMRA and digital subtraction angiography(DSA)in the evaluation of abnormal types of vertebral artery and basilar artery blood vessels.DSA was used as the gold standard to analyze the diagnostic value of 3D-TOF-MRA on intracranial vertebral-basilar lesions.Results The Kappa values of 3D-TOF-MRA and DSA in evaluating abnormal types of vertebral artery and basilar artery blood vessels were 0.874 and 0.862 respectively,indicating good consistency.Taking DSA as the gold standard,the sensitivity,specificity and accuracy of 3D-TOF-MRA were 94.74%,92.41%,93.33%in the diagnosis of intracranial vertebral-basilar lesions.Vertebral artery hypoplasia in 3D-TOF-MRA showed thin blood vessels,arterial dissection showed stenosis or occlusion and atherosclerosis showed uniform thickening.Vertebral artery hypoplasia in 3D-TOF-MRA showed thin blood vessels,arterial dissection showed stenosis or occlusion and atherosclerosis showed uniform thickening.Conclusion 3D-TOF-MRA has a high diagnostic value on intracranial vertebral-basilar lesions,and its identification of abnormal types of vertebral artery and basilar artery blood vessels is consistent with DSA.