| 梁高,余薇,宫宁,曾利川,胡琴,侯中华,谢明国.三维动脉自旋标记与磁敏感加权血管造影评价急性缺血性脑血管病颅内动脉狭窄[J].中国医学影像技术,2022,38(1):44~48 |
| 三维动脉自旋标记与磁敏感加权血管造影评价急性缺血性脑血管病颅内动脉狭窄 |
| Three-dimensional arterial spin labeling and susceptibility weighted angiography for evaluation on intracranial arterialstenosis with acute ischemia cerebrovascular disease |
| 投稿时间：2020-04-27 修订日期：2021-10-17 |
| DOI：10.13929/j.issn.1003-3289.2022.01.011 |
| 中文关键词: 脑血管疾病 磁共振成像 磁共振血管造影术 |
| 英文关键词:cerebrovascular disorders magnetic resonance imaging magnetic resonance angiography |
| 基金项目:四川省干部保健科研课题(川干研-2019-507) |
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| 中文摘要: |
| 目的 评价三维动脉自旋标记(3D-ASL)明亮血管征(BVS)及磁敏感加权血管造影(SWAN)磁敏感血管征(SVS)诊断急性缺血性脑血病(AICVD)颅内动脉狭窄的价值。方法 对101例AICVD患者采集颅脑3D-ASL及SWAN图像, 以Kappa检验评价观察者间诊断BVS和SVS的一致性。以CT血管造影(CTA)结果为标准(39例阳性), 评价BVS与SVS检出颅内动脉狭窄的效能; 根据动脉狭窄位置分为大动脉狭窄亚组(n=16)和中小动脉狭窄亚组(n=23), 比较BVS与SVS检出大动脉狭窄与中小动脉狭窄的一致性及其诊断差异。结果 观察者间判断BVS及SVS的一致性高(Kappa均≥0.8, P均＜0.05)。3D-ASL显示BVS阳性30例、阴性71例, SWAN显示SVS阳性23例、阴性78例; 根据BVS及SVS诊断颅内动脉狭窄的敏感度、特异度和准确率分别为74.36%、98.39%及89.11%和56.41%、98.39%及82.18%。BVS与SVS判断颅内大动脉狭窄的一致性良好(Kappa=0.61, P=0.01), 诊断差异无统计学意义(P＞0.05);BVS与SVS诊断颅内中小动脉狭窄的一致性中等(Kappa=0.43, P=0.01), 而BVS阳性率(82.61%, 19/23)显著高于SVS(56.52%, 13/23)(P＜0.05)。结论 BVS与SVS诊断AICVD颅内动脉狭窄的效果均较好, 二者对大动脉狭窄诊断效能相近, BVS对中小动脉狭窄更优。 |
| 英文摘要: |
| Objective To observe the value of bright vessel sign (BVS) on three-dimensional arterial spin labeling (3D-ASL), as well as of susceptibility vessel sign (SVS) on susceptibility weighted angiography (SWAN) for diagnosing acute ischemic cerebrovascular disease (AICVD).Methods Brain 3D-ASL and SWAN were performed in 101 patients with AICVD. Kappa test was used to evaluate the intra-observer diagnostic consistency of BVS and SVS. Taken CTA results as the diagnostic criteria (39 positive cases), the efficiency of BVS and SVS for diagnosing intracranial arterial stenosis was evaluated. Then patients with stenosis were divided into large arterial stenosis subgroup (n=16) and middle and small arterial stenosis subgroup (n=23). The consistency and differences of BVS and SVS for diagnosing large and the middle and small arterial stenosis were analyzed.Results High inter-observer consistency of BVS and SVS was found for diagnosing arterial stenosis of AICVD (all Kappa≥0.8, all P < 0.05). 3D-ASL showed BVS positive in 30 cases and BVS negative in 71 cases. SWAN showed SVS positive in 23 cases and SVS negative in 78 cases. The sensitivity, specificity and accuracy of BVS for diagnosing intracranial arterial stenosis was 74.36%, 98.39% and 89.11%, of SVS was 56.41%, 98.39% and 82.18%, respectively. There was good consistency between BVS and SVS for diagnosing intracranial large arterial stenosis (Kappa=0.61, P=0.01), but no statistical difference of diagnosis was found (P > 0.05). There was moderately consistent between BVS and SVS for diagnosing intracranial middle and small arterial stenosis (Kappa=0.43, P=0.01). The positive rate of BVS (82.61%, 19/23) was significantly higher than that of SVS (56.52%, 13/23) (P < 0.05).Conclusion BVS and SVS were both effective for intracranial arterial stenosis of AICVD, having similar performances in diagnosis of large arterial stenosis, while BVS was better in detecting small-medium arterial stenosis of AICVD. |
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