磁共振血管造影在缺血性脑血管病中的诊断价值分析

Diagnostic Value of Magnetic Resonance Angiography in Ischemic Cerebrovascular Disease

目的:探究磁共振血管造影(MRA)在缺血性脑血管病(ICVD)中的诊断价值。方法:选择2019年5月—2022年5月在张家港市第一人民医院接受治疗的60例疑似ICVD的患者作为研究对象。所有患者同时接受磁共振血管造影检查和CT检查,以数字减影血管造影(DSA)为金标准,对比两种检查方法的诊断准确率、特异度、敏感度、阳性预测值、阴性预测值。结果:60例疑似ICVD患者经DSA诊断为ICVD的有48例,非ICVD的有12例。MRA诊断ICVD的准确率为96.67%,高于CT诊断的71.67%,差异有统计学意义(P<0.05);MRA诊断ICVD的特异度、敏感度、阳性预测值及阴性预测值高于CT检查,差异有统计学意义(P<0.05)。在DSA诊断的48例确诊为ICVD的患者中,有短暂性脑缺血发作(TIA)17例,脑梗死22例,颈动脉狭窄9例;MRA诊断短暂性脑缺血、脑梗死及颈动脉狭窄的符合率高于CT检查,差异有统计学意义(P<0.05)。结论:在疑似ICVD患者的检查中,MRA和CT检查都具有一定的准确性,但是MRA检查的特异度、敏感度和准确性更高,在临床对ICVD患者中更具有参考价值。

Objective:To explore the diagnostic value of magnetic resonance angiography(MRA)in ischemic cerebrovascular disease(ICVD).Method:A total of 60 patients with suspected ICVD who were treated in Zhangjiagang First People's Hospital from May 2019 to May 2022 were selected as the study subjects.All patients underwent MRA and CT at the same time.Digital subtraction angiography(DSA)was used as the gold standard to compare the diagnostic accuracy,specificity,sensitivity,positive predictive value and negative predictive value of the two groups.Result:Of the 60 suspected ICVD patients,48 cases were diagnosed as ICVD by DSA,and 12 cases were non ICVD.The accuracy rate of MRA in diagnosing ICVD was 96.67%,which was higher than 71.67%of CT diagnosis,the difference was statistically significant(P<0.05).The specificity,sensitivity,positive predictive value,and negative predictive value of MRA in diagnosing ICVD were significantly higher than those of CT,the differences were statistically significant(P<0.05).Among the 48 patients diagnosed with ICVD by DSA,there were 17 cases of transient ischemic attack(TIA),22 cases of cerebral infarction,and 9 cases of carotid stenosis.The accuracy of MRA in diagnosing transient cerebral ischemia,cerebral infarction,and carotid stenosis were higher than those of CT,the differences were statistically significant(P<0.05).Conclusion:In the examination of suspected ICVD patients,both MRA and CT examinations have certain accuracy,but the specificity,sensitivity,and accuracy of MRA examinations are higher,and they have more reference value for ICVD patients in clinical practice.