CE-MRA与TOF-MRA对头颈部动脉瘤诊断价值的对比研究  

Compared study of diagnostic value of CE-MRA and TOF-MRA in cerebral and cervical aneurysm

作　　者：沙琳[1] 边杰[1] 程绍玲[1] 黄东[1] 董敬东[1] 

机构地区：[1]大连医科大学第二临床学院放射科,辽宁大连116027

出　　处：《大连医科大学学报》2008年第1期56-60,共5页Journal of Dalian Medical University

基　　金：大连市科技局科技发展基金(2005E21SF130)

摘　　要：[目的]通过造影增强(contrast enhance,MRA,CE-MRA)与时间飞跃技术磁共振血管成像(Time-Of-Flighttechnique,MRA TOF-MRA)对头颈部动脉瘤诊断的前瞻性对比研究,探讨二者对头颈部动脉瘤的诊断价值。[方法]临床怀疑头颈部动脉瘤患者共100人,经手术或DSA证实头72个动脉瘤病灶,所有患者均行TOF-MRA与CE-MRA检查,对TOF-MRA与CE-MRA的诊断价值进行评价。评价内容:二者对头部动脉瘤诊断的敏感性、特异性、正确率;对合并出血的动脉瘤的显示,对动脉瘤腔内血栓的评价比较。[结果]CE-MRA对头颈部动脉瘤诊断的敏感性97.2%(70/72)、特异性100%(28/28)、正确率(98%);TOF-MRA对头颈部动脉瘤诊断的敏感性83.3%(60/72)、特异性46.4%(13/28)、正确率73%,配对χ2检验显示二者的敏感性(χ2=8.1)、特异性(χ2=13.1)、正确率(χ2=12.1)差异均有显著性意义,P<0.01;TOF-MRA未显示14例合并出血动脉瘤病灶,CE-MRA对该14个动脉瘤均做出准确评价;TOF-MRA显示37例瘤腔内血栓中16例证实为伪影,CE-MRA对21例瘤腔内血栓均做出准确评价。[结论]TOF-MRA可以作为疑似头部动脉瘤患者的筛选检查,当临床高度怀疑存在颅内动脉瘤而TOF-MRA无异常发现,或由于合并颅内出血TOF-MRA无法明确是否存在动脉瘤,以及需要对瘤腔内是否存在血栓做出准确评价时应选择CE-MRA检查。[ Objective] To prospectively compare the diagnostic value of CE -MRA and TOF- MRA in cerebral and cervical aneurysm. [ Methods ] One hundred patients with clinical suspected cerebral and cervical aneurysm were enrolled and 72 aneurysms were demonstrated by surgery or DSA. TOF- MRA and CE -MRA were undertaken by every subject for evaluation. Contents of evaluation included the sensitivity, specificity and accuracy in aneurysm diagnosis ; exposure of combined hemorrhage and thrombus in the aneurysm sac. [ Results ] The sensitivity, specificity and accuracy of CE - MRA in the diagnosis of cerebral and cervical aneurysm were 97.2% （70/72） , 100% （28/28） and 98% , while those of TOF - MRA were 83.3% （60/72） ,46.4% （ 13/28 ） and 73%, respectively. Pair Χ^2 - test showed significant difference between them （P 〈0.01 ）. 14 combining hemorrhage lesions in TOF- MRA were accurately assessed by CE- MRA. Among 37 thromboses in aneurysm sacs, 16 cases were demonstrated to be artifact and 21 thromboses in the aneurysm sacs were correctly evaluated by CE - MRA. [ Conclusions ] TOF - MRA should be used for screening of cerebral and cervical aneurysm. When no abnormality was found by TOF - MRA in highly - suspected cerebral and cervical aneurysm or cerebral hemor- rhage, CE - MRA was recommended. So did the evaluation of thrombus in the aneurysm sac.

关 键 词：磁共振 动脉瘤 血管成像 

分 类 号：R739.91[医药卫生—肿瘤]