高分辨率压缩感知TOF-MRA在烟雾病分期及出血相关血管评估中的临床价值

Clinical value of high-resolution compressed sensing TOF-MRA in assessing Suzuki classification and the dilatation of hemorrhage related vascular in patients with moyamoya disease

目的 探讨高分辨率压缩感知(compressed sensing, CS)时间飞跃法磁共振血管造影(time-of-fight magnetic resonance angiography, TOF-MRA)在烟雾病(moyamoya disease, MMD)分期及出血相关血管评估中的应用价值。材料与方法 回顾性分析同时行CS TOF-MRA和CT血管成像(computed tomography angiography, CTA)的MMD患者资料21例,两次检查时间间隔不超过2周。CS TOF-MRA扫描时间5 min 4 s,重建体素大小0.4 mm×0.4 mm×0.4 mm。两名放射科医生分别在CS TOF-MRA和CTA上对Suzuki分期、烟雾状血管(moyamoya vessel, MMV)、脉络膜前动脉(anterior choroidal artery, AChA)及后交通动脉(posterior communicating artery, PComA)的显示能力进行评价,并以单侧大脑半球为单位对AChA、PComA有无扩张进行分级评估。采用配对样本Wilcoxon秩和检验,将CS TOF-MRA及CTA评估结果进行对比分析。结果 研究共纳入37个大脑半球(5例单侧MMD,16例双侧MMD)。CS TOF-MRA对Suzuki分期评价能力与CTA相当(Z=-1.000,P>0.05),对MMV、AChA及PComA的显示能力均优于CTA(P值均<0.05)。CS TOF-MRA对AChA、PComA扩张分级评估能力与CTA相当(P值均<0.05)。结论 在临床合理的扫描时间内,高分辨率CS TOF-MRA序列对MMD出血相关血管的显示优于CTA,Suzuki分期和血管扩张分级评估与之相当,可作为MMD患者随访复查优先选择的影像学检查方法,具有较高的临床应用价值。

Objective:To explore the applied value of high-resolution compressed sensing(CS)time-of-fight magnetic resonance angiography(TOF-MRA)in assessing Suzuki classification and the dilatation of hemorrhage related vascular in patients with moyamoya disease(MMD).Materials and Methods:A retrospective analysis of twenty-one receivers who underwent both CS TOF-MRA and computed tomography angiography(CTA)within 2 weeks.The scan time of CS TOF-MRA was 5 min 4 s,with a reconstructed resolution of 0.4 mm×0.4 mm×0.4 mm.Visualization of Suzuki classification,moyamoya vessel(MMV),anterior choroidal artery(AChA),and posterior communicating artery(PComA)were independently ranked by two neuroradiologists on CS TOF-MRA and CTA,respectively.The unilateral cerebral hemisphere as a unit,the dilatation of AChA and PComA were graded using both CS TOF-MRA and CTA.Wilcoxon rank sum test was used to compare the evaluation results of CS TOF-MRA and CTA.Results:The evaluation ability of Suzuki classification,CS TOF-MRA was equivalent to CTA(Z=-1.000,P>0.05).The MMV,AChA and PComA were better visualized on CS TOF-MRA than CTA(both P<0.05).Thirty-seven hemisphere were enrolled(5 cases of unilateral MMD and 16 cases of bilateral MMD),the dilatation of AChA and PComA,were comparable to CTA(both P<0.05).Conclusions:Within a clinically reasonable time,high-resolution CS TOF-MRA outperforms CTA for visualization of hemorrhage related vascular and is equivalent to CTA for Suzuki classification and the dilatation of hemorrhage related vascular in MMD patients.High-resolution CS TOF-MRA can be used as a priority imaging examination for follow-up review of MMD patients,and has well applied value in clinical practice.