颈脑血管一体化超声及高分辨MRI 3D黑血技术在脑梗死中的诊断价值

The diagnostic value of carotid integrative ultrasound and high-resolution MRI 3D black blood technique in cerebral infarction

目的 分析颈脑血管一体化超声及高分辨磁共振(MRI) 3D黑血技术在脑梗死中的诊断价值。方法 于2022年4月~2024年1月在我院及外院收集病例展开研究,将112例脑梗死患者作为研究对象。所有患者均由同一名医生应用颈动脉血管超声+经颅多普勒超声技术同时对颈动脉及脑动脉进行整体化评估即一体化超声检查,所有患者均在本院或外院行高分辨MRI 3D黑血技术诊断,以数字减影血管造影(DSA)结果为“金标准”,对比颈脑血管一体化超声及高分辨MRI 3D黑血技术对血管狭窄>70%和溃疡斑块的诊断效果。结果 DSA检查显示74例患者血管狭窄>70%;采用颈脑血管一体化超声检查出64例真阳性,30例真阴性;采用高分辨MRI 3D黑血技术检查出71例真阳性,36例真阴性。高分辨MRI 3D黑血技术诊断血管狭窄>70%的诊断灵敏度、特异度、准确度分别为95.95%(71/74)、94.74%%(36/38)、94.64%(106/112),较颈脑血管一体化超声86.94%(64/74)、78.95%(30/38)、84.82%(95/112)高(P<0.05)。DSA检查显示60例患者存在溃疡斑块;采用颈脑血管一体化超声检查出52例真阳性,44例真阴性;采用高分辨MRI 3D黑血技术检查出58例真阳性,50例真阴性。高分辨MRI 3D黑血技术诊断溃疡斑块的诊断灵敏度、特异度、准确度分别为86.67%(58/60)、96.15%(50/52)、96.43%(108/112),较颈脑血管一体化超声86.67%(52/60)、84.62%(44/52)、85.71%(96/112)高(P<0.05)。结论 与颈脑血管一体化超声相比,高分辨MRI 3D黑血技术应用于脑梗死诊断中,可提高血管狭窄和溃疡斑块诊断效果。

Objective To analyze the diagnostic value of carotid integrative ultrasound and high-resolution magnetic resonance imaging(MRI)3D blackblood in cerebral infarction.Methods From April 2022 to January 2024,112 patients with cerebral infarction were collected and studied in our hospital and other hospitals.The results of digital subtraction angiography(DSA)were used as the"gold standard"to compare the diagnostic effects of cervical cerebrovascular integration ultrasound and high-resolution MRI 3D black blood technology on vascular stenosis>70%and ulcerative plaque.Results DSA showed that 74 patients had vascular stenosis>70%.64 cases of true positive and 30 cases of true negative were detected by carotid integrative ultrasonography.High-resolution MRI 3D black blood technique was used to detect 71 true positive cases and 36 true negative cases.The diagnostic sensitivity,specificity and accuracy of high resolution MRI 3D black blood technique for diagnosing vascular stenosis>70%were 95.95%(71/74),94.74%(36/38)and 94.64%(106/112),respectively.It was higher than 86.94%(64/74),78.95%(30/38),84.82%(95/112)(P<0.05).DSA showed the presence of ulcerative plaque in 60 patients.By ultrasonography,52 cases were true positive and 44 cases were true negative.Using high-resolution MRI 3D black blood technique,58 cases were true positive and 50 were true negative.The diagnostic sensitivity,specificity and accuracy of high-resolution MRI 3D blackblood in the diagnosis of ulcerative plaque were 86.67%(58/60),96.15%(50/52)and 96.43%(108/112),respectively.It was higher than that of carotid cerebrovascular integration ultrasound 86.67%(52/60),84.62%(44/52),85.71%(96/112)(P<0.05).Conclusion Compared with carotid integrative ultrasound,the application of high-resolution MRI 3D black blood technique in the diagnosis of cerebral infarction can improve the diagnosis effect of vascular stenosis and ulcerative plaque.