颈动脉窦3D TOF MRA涡流伪影的征象分析  

Analysis of Vortex Flow Artifacts at the Carotid Bulb on 3D TOF MRA

作　　者：张靖博[1] 王苇[1] 杜芳[1] 李澄[1] 

机构地区：[1]扬州市第一人民医院放射科,江苏225001

出　　处：《放射学实践》2008年第1期77-80,共4页Radiologic Practice

摘　　要：目的:探讨颈动脉窦3D TOF MRA在涡流伪影与真性狭窄鉴别诊断中的意义。方法:回顾性分析40例患者、80根颈动脉的3D TOF MRA和DSA的影像资料,以DSA为金标准分析颈动脉窦3D TOF MRA以下特征性表现:颈动脉窦后壁轮廓存在与否;充盈缺损的后缘边界;充盈缺损的信号强度;充盈缺损是否累及颈总动脉。结果:3D TOF MRA显示颈动脉窦异常21处,其中涡流伪影14处,真性狭窄7处。14处涡流伪影表现为颈动脉窦后壁轮廓存在12处,充盈缺损的后缘边界模糊13处,信号强度明显弱于颈总动脉11处,未累及颈总动脉9处。7处真性狭窄表现为颈动脉窦后壁轮廓局部缺失7处,充盈缺损的后缘边界锐利6处,信号强度与周围背景信号相同7处,累及颈总动脉4处。χ2检验以上四种征象在鉴别涡流伪影和真性狭窄上差异均具有统计学意义(P<0.05)。采用上述鉴别诊断征象后,3D TOF MRA诊断颈动脉狭窄的特异度明显提高。结论:颈动脉窦3D TOF MRA在鉴别涡流伪影与真性狭窄上具有重要意义。Objective：To study the features for the differential diagnosis between vortex flow artifacts and true stenosis at the carotid bulb on 3D TOF MRA. Methods：Images of 80 extracranial carotid arteries were collected from 40 patients who underwent both 3D TOF MRA and digital subtraction angiography （DSA） ,and the findings were retrospectively analyzed. Using DSA as the gold standard,the following signs at the carotid bulb on 3D TOF MRA were analyzed：preservation of the contour of posterior carotid bulb wall, posterior margin of filling defect, signal intensity of the filling defect, involvement of common carotid artery by the filling defect. Results： There were 21 abnormalities including vortex flow artifacts （n= 14） true stenosis （n= 7）. Of the 14 vortex flow artifacts, preservation of the posterior wall contour （12/14）,vagueness of posterior contour of the filling defect （13/14）,markedly lower signal intensity than that of common carotid artery （11/ 14） ,no involvement of the common carotid artery （9/14） were assessed. Of the 7 true stenosis,loss of focal posterior wall contour of carotid bulb （7/7） ,sharp posterior margin of the filling defect （6/7） ,similar signal intensity of the filling defect to that of surrounding background （7/7）,involvement of common carotid artery （4/7） were showed. Of these above-mentioned items, statistical significant differences were existed between vortex flow artifacts group and true stenotic defect group （P〈0.05, χ^2 analysis）. The specificity of 3D TOF MRA for carotid bulb stenosis was markedly increased after application of above-mentioned features. Conclusion：The above-mentioned features were very helpful in the differential diagnosis of vortex flow artifacts from true stenosis on 3D TOF MRA.

关 键 词：磁共振血管造影术 图像处理 计算机辅助 颈动脉窦 

分 类 号：R543.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]