HR-MRI对基底动脉粥样硬化狭窄的诊断价值

The diagnostic value of HR-MRI for basilar artery atherosclerotic stenosis

目的探讨3.0 T高分辨率磁共振成像(HR-MRI)对基底动脉粥样硬化狭窄疾病的诊断价值。方法选择2018年7月至2022年10月临床诊断为缺血性脑血管病并行HR-MRI、数字减影血管造影(DSA)检查的患者72例,以DSA为诊断金标准,分析HR-MRI评估基底动脉粥样硬化狭窄的诊断效能。结果72例患者中67例(93.1%)MRI图像质量符合要求。HR-MRI和DSA对基底动脉狭窄率测量结果有较好的相关性(R^(2)=0.953,P<0.001)。HR-MRI和DSA共评估55例患者的基底动脉狭窄程度一致,符合率为82.1%,一致性良好(Kappa=0.754,P<0.001)。HR-MRI诊断的准确率为94.0%,灵敏度为91.7%,特异度为100%,阳性预测值为100%,阴性预测值为82.6%。结论HR-MRI作为一种新型评估血管病变的无创影像学工具,在基底动脉粥样硬化性狭窄诊断方面与DSA有较好的一致性,有望成为替代DSA有创检查的重要选择。

Objective To explore the diagnostic value of 3.0 T high-resolution magnetic resonance imaging(HR-MRI)for basilar atherosclerotic stenosis lesions.Methods From July 2018 to October 2022,72 patients who were clinically diagnosed with ischemic cerebrovascular disease and underwent HR-MRI and digital subtraction angiography(DSA)examination were included as the research subjects,and DSA was used as the gold standard for diagnosis to analyze HR-MRI to evaluate the diagnostic performance of basilar atherosclerotic stenosis.Results There were 67 cases of 72 patients with basilar artery image quality meeting the requirements(93.1%),and there was a good correlation between the basilar artery stenosis rate by HR-MRI and DSA(R^(2)=0.953,P<0.001).There were up to 55 cases with the same degree of basilar artery stenosis assessed by HR-MRI and DSA,the diagnosis coincidence rate was 82.1%,there was a good agreement(Kappa=0.754,P<0.001).The accuracy of HR-MRI diagnosis was 94.0%,sensitivity was 91.7%,specificity was 100%,positive predictive value was 100%,and negative predictive value was 82.6%.Conclusion HR-MRI,as a new non-invasive imaging tool for evaluating vascular lesions,has good consistency with DSA in the diagnosis of basilar atherosclerotic stenosis,which is expected to become an important alternative to DSA invasive examination.