三维增强磁共振血管造影在颅内动脉瘤中的应用  

The Application of Three--dimensional Contrast--Enhanced MR Angiography in Diagnosing Intracranial Aneurysms

作　　者：史丽静[1] 田树平[1] 郑奎宏[1] 郭勇[1] 林伟[1] 黄敏华[1] 

机构地区：[1]海军总医院影像中心磁共振室,北京100048

出　　处：《实用放射学杂志》2010年第5期616-619,共4页Journal of Practical Radiology

摘　　要：目的 评价三维增强磁共振血管造影（3D CE-MRA） 在颅内动脉瘤诊断中的应用价值.方法 77例高度怀疑颅内动脉瘤的患者,分别完成3D CE-MRA（图像以VR、MIP、MPR 3种方法显示）和DSA检查,以DSA结果为依据,评价3D CE-MRA对颅内血管瘤的诊断价值.结果 77例中,62例有颅内动脉瘤共73个,3D CE-MRA共诊断65个,漏诊8个.无动脉瘤者15例,3D CE-MRA正确诊断8例,另7例误诊为动脉瘤.3D CE-MRA对动脉瘤的敏感度为89.0%（65/73）,特异度为53.3%（8/15）,准确度为82.9%[（65＋8）/（73＋15）].结论 3D CE-MRA对微小动脉瘤及周边部小动脉瘤的确诊率不高,对动脉分叉、动脉圆锥及该处小动脉瘤的诊断应谨慎.Objective To assess the application of three--dimensional contrast--enhanced MR angiography （3D CE MRA） in diagnosing intracranial aneurysms. Methods 77 patients who were suspected to have intracranial aneurysm underwent 3D CE MRA and digital subtraction angiography （DSA）. The post--processing methods of 3D CE MRA included：volume rendering （VR）, maximum intensity projection （MIP） and multiplanar reconstruction （MPR）. The diagnostic value of 3D CE MRA for intracranial aneurysms was analysed comparatively with DSA results. Results 73 intracranial aneurysms were found by DSA in 62 of the 77 patients. 65 of these aneurysms were diagnosed correctly by 3D CE MRA, the other 8 were not displayed on MRA images. Among the 15 patients without aneurysm in DSA, 8 of them were also demonstrated by 3D CE MRA, whereas 7 of them were misdiagnosed as small aneurysm. The sensitivity, specificity, and accuracy of diagnosing intracranial aneurysms with 3D CE MRA were 89.0%, 53.3% and 82.9%, respectively. Conclusion The diagnostic accuracy is not satisfied in diagnosing intracranial micro--aneurysms and those located in the periphery with 3D MRA and the diagnosis should be carefully for small aneurysms at the artery bifurcation and artery conus.

关 键 词：脑 动脉瘤 磁共振血管造影术 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]