目的:比较3.0 T磁共振血管造影(MRA)与1.5 T MRA对未破裂颅内动脉瘤(IA)的诊断价值。方法:回顾性分析在宜昌市中心人民医院同时行MRA和数字减影血管造影(DSA)检查的患者影像学资料。以DSA为金标准,比较3.0 T MRA与1.5 T MRA对IA及其瘤...目的:比较3.0 T磁共振血管造影(MRA)与1.5 T MRA对未破裂颅内动脉瘤(IA)的诊断价值。方法:回顾性分析在宜昌市中心人民医院同时行MRA和数字减影血管造影(DSA)检查的患者影像学资料。以DSA为金标准,比较3.0 T MRA与1.5 T MRA对IA及其瘤颈、子囊的检出率。同时比较两种方法与DSA测量IA最长直径(LD)的一致性和相关性。结果:3.0 T MRA和1.5 T MRA的IA检出率分别为89.92%和85.05%,差异无统计学意义(P>0.05)。3.0 T MRA瘤颈、子囊检出率分别为59.81%、26.17%,显著高于1.5 T MRA的38.46%、15.93%(均P<0.05)。3.0 T MRA、1.5 T MRA与DSA测量瘤体LD呈高度正相关,其相关性可达0.984和0.983;3.0 T MRA、1.5 T MRA与DSA测量瘤体LD差值分别为0.30(95%CI:-0.35,0.94)mm和0.66(95%CI:0.12,1.21)mm。1.5 T MRA的LDMRA/LDDSA值较3.0 T MRA更小,差异有统计学意义(P<0.05)。结论:3.0 T MRA与1.5 T MRA在IA的检出上无差异,但3.0 T MRA对IA瘤颈、子囊的检出率更高、形态学指标测量也更加精确。展开更多
Objective:To determine whether cervical ultrasonography,magnetic resonance imaging(MRI),and magnetic resonance angiography(MRA)are useful in the differential diagnosis of etiology and understanding the pathophysiology...Objective:To determine whether cervical ultrasonography,magnetic resonance imaging(MRI),and magnetic resonance angiography(MRA)are useful in the differential diagnosis of etiology and understanding the pathophysiology in cases of apogeotropic direction-changing positional nystagmus(DCPN).Methods:Thirty patients with apogeotropic DCPN were classified into 11 cases of central disease,seven cases of mixed central and peripheral disease,and 12 cases of peripheral disease by differential diagnosis based on various balance function,neuro-otological,and imaging tests.Cervical ultrasonography using the cervical rotation method and MRI and MRA of the head and neck were performed in most patients with apogeotropic DCPN.We reviewed the presence of abnormal imaging findings according to the disease etiology.Results:Of the 30 patients with apogeotropic DCPN,23 showed vascular abnormalities or central lesions on imaging.Vascular lesions were found in six of the 12 patients with peripheral disease.Cervical ultrasonography with cervical rotation detected blood flow disturbance in the vertebral artery in eight patients in whom the disturbance could not be detected by MRI or MRA of the head and neck.Discussion:We hypothesize that the causative disease of apogeotropic DCPN may be strongly associated with circulatory insufficiency of the vertebrobasilar and carotid arteries,and that impaired blood flow in these vessels may affect peripheral vestibular and central function.In patients with apogeotropic DCPN,examinations of vestibular function,central nervous system symptoms,and brain hemodynamics are valuable for differential diagnosis.展开更多
目的:探讨时间飞跃法磁共振血管成像(three-dimensional time of flight MRA,3D-TOF-MRA)与CT血管造影(CT angiography,CTA)对未破裂颅内动脉瘤(unruptured intracranial aneurysms,UIAs)的诊断价值。方法:回顾性收集2019年7月—2022年...目的:探讨时间飞跃法磁共振血管成像(three-dimensional time of flight MRA,3D-TOF-MRA)与CT血管造影(CT angiography,CTA)对未破裂颅内动脉瘤(unruptured intracranial aneurysms,UIAs)的诊断价值。方法:回顾性收集2019年7月—2022年6月经数字减影血管造影(digital subtraction angiography,DSA)确诊为UIAs 52例患者的3D-TOF-MRA及CTA图像,比较MRA和CTA对颅内动脉瘤的检出率、瘤体最大径及瘤体颈宽测量结果的差异,MRA和CTA对颅内动脉瘤检出的一致性采用Kappa检验。结果:DSA确诊的52例患者中,共检出动脉瘤63个,MRA及CTA分别检出真实动脉瘤52个及53个,检出率分别为82.54%及84.13%,两者的差异无统计学意义(P>0.05),且两者对颅内动脉瘤的检出具有良好的一致性(Kappa=0.94);MRA与CTA对颅内动脉瘤瘤体最大径及瘤体颈宽测量结果的差异无统计学意义(P>0.05)。结论:3D-TOF-MRA与CTA在UIAs的诊断中均具有较高的价值,但3D-TOF-MRA是一种无电离辐射、无需注射对比剂的无创检查,方便重复检查,故UIAs的筛查和定期随访首选3D-TOF-MRA。展开更多
文摘目的:比较3.0 T磁共振血管造影(MRA)与1.5 T MRA对未破裂颅内动脉瘤(IA)的诊断价值。方法:回顾性分析在宜昌市中心人民医院同时行MRA和数字减影血管造影(DSA)检查的患者影像学资料。以DSA为金标准,比较3.0 T MRA与1.5 T MRA对IA及其瘤颈、子囊的检出率。同时比较两种方法与DSA测量IA最长直径(LD)的一致性和相关性。结果:3.0 T MRA和1.5 T MRA的IA检出率分别为89.92%和85.05%,差异无统计学意义(P>0.05)。3.0 T MRA瘤颈、子囊检出率分别为59.81%、26.17%,显著高于1.5 T MRA的38.46%、15.93%(均P<0.05)。3.0 T MRA、1.5 T MRA与DSA测量瘤体LD呈高度正相关,其相关性可达0.984和0.983;3.0 T MRA、1.5 T MRA与DSA测量瘤体LD差值分别为0.30(95%CI:-0.35,0.94)mm和0.66(95%CI:0.12,1.21)mm。1.5 T MRA的LDMRA/LDDSA值较3.0 T MRA更小,差异有统计学意义(P<0.05)。结论:3.0 T MRA与1.5 T MRA在IA的检出上无差异,但3.0 T MRA对IA瘤颈、子囊的检出率更高、形态学指标测量也更加精确。
文摘Objective:To determine whether cervical ultrasonography,magnetic resonance imaging(MRI),and magnetic resonance angiography(MRA)are useful in the differential diagnosis of etiology and understanding the pathophysiology in cases of apogeotropic direction-changing positional nystagmus(DCPN).Methods:Thirty patients with apogeotropic DCPN were classified into 11 cases of central disease,seven cases of mixed central and peripheral disease,and 12 cases of peripheral disease by differential diagnosis based on various balance function,neuro-otological,and imaging tests.Cervical ultrasonography using the cervical rotation method and MRI and MRA of the head and neck were performed in most patients with apogeotropic DCPN.We reviewed the presence of abnormal imaging findings according to the disease etiology.Results:Of the 30 patients with apogeotropic DCPN,23 showed vascular abnormalities or central lesions on imaging.Vascular lesions were found in six of the 12 patients with peripheral disease.Cervical ultrasonography with cervical rotation detected blood flow disturbance in the vertebral artery in eight patients in whom the disturbance could not be detected by MRI or MRA of the head and neck.Discussion:We hypothesize that the causative disease of apogeotropic DCPN may be strongly associated with circulatory insufficiency of the vertebrobasilar and carotid arteries,and that impaired blood flow in these vessels may affect peripheral vestibular and central function.In patients with apogeotropic DCPN,examinations of vestibular function,central nervous system symptoms,and brain hemodynamics are valuable for differential diagnosis.
