磁共振血管成像与三维动脉自旋标记脑灌注成像技术对缺血性脑血管疾病患者的诊断价值

Diagnostic value of magnetic resonance angiography and three-dimensional arterial spin labeled cerebral perfusion imaging technology in patients with ischemic cerebrovascular diseases

目的对比磁共振血管成像(MRA)与三维动脉自旋标记(3D-ASL)脑灌注成像技术对缺血性脑血管疾病患者的诊断价值。方法回顾性分析2021年1月至2022年1月本院收治的58例缺血性脑血管疾病患者的临床资料和影像学资料,所有患者均接受MRA、3DASL、数字减影血管造影(DSA)检查,以DSA检查结果为金标准,比较MRA、3D-ASL检查的诊断符合率及与DSA检查的一致性,并比较MRA、3D-ASL检查对缺血性脑血管中各类型疾病的诊断价值。结果3D-ASL检查在短暂性脑缺血、小面积脑梗死以及大面积脑梗死中的诊断符合率均高于MRA检查,且诊断总符合率明显高于MRA检查(P<0.05)。与MRA检查比较,3D-ASL检查与DSA检查的诊断一致性较好(Kappa=0.337、0.561)。3D-ASL检查在短暂性脑缺血、小面积脑梗死、大面积脑梗死诊断中的灵敏度、特异度以及准确度均高于MRA检查(P<0.05)。结论与MRA检查比较,3D-ASL脑灌注成像技术应用于缺血性脑血管疾病中可提升诊断的准确性,减少漏诊,对各类型疾病的诊断价值也更高,值得临床推广应用。

Objective To compare and analyze the diagnostic value of magnetic resonance angiography(MRA)and three-dimensional arterial spin labeling(3D-ASL)cerebral perfusion imaging technology in patients with ischemic cerebrovascular disease.Methods The clinical data and imaging data of 58 patients with ischemic cerebrovascular diseases admitted to our hospital from January 2021 to January 2022 were analyzed retrospectively.All patients received MRA,3D-ASL,and digital subtraction angiography(DSA).The DSA results were used as the gold standard to compare the diagnostic coincidence rate and consistency with DSA,and the diagnostic value of MRA and 3D-ASL in various types of ischemic cerebrovascular diseases.Results The diagnostic coincidence rate of 3D-ASL in transient cerebral ischemia,small area cerebral infarction and large area cerebral infarction was higher than that of MRA,and the total diagnostic coincidence rate was significantly higher than that of MRA(P<0.05).Compared with MRA,the diagnostic consistency of 3D-ASL and DSA was good(Kappa=0.337,0.561).The sensitivity,specificity and accuracy of 3D-ASL in the diagnosis of transient cerebral ischemia,small area cerebral infarction and large area cerebral infarction were higher than those of MRA(P<0.05).Conclusion Compared with MRA,the application of 3D-ASL cerebral perfusion imaging technology in ischemic cerebrovascular diseases can improve the accuracy of diagnosis,reduce missed diagnosis,and have higher diagnostic value for various types of diseases,which is worthy of clinical promotion and application.