非增强MRA诊断下肢动脉病变的应用研究  

Evaluation of non-contrast-enhanced MR angiography in patients with lower extremity peripheral arterial disease

作　　者：冯飞[1] 刘晓怡[1] 戚玉龙[1] 刘汉桥[1] 田鑫[1] 刘新[2] 刘鹏程[1] 

机构地区：[1]北京大学深圳医院医学影像科,广东518036 [2]中国科学院深圳先进技术研究院生物医学成像研究中心,广东518055

出　　处：《放射学实践》2012年第11期1267-1270,共4页Radiologic Practice

摘　　要：目的:探讨QISS非增强MRA技术诊断下肢动脉闭塞性病变的临床应用价值。方法:51例下肢动脉病变患者行双下肢QISS-MRA和CE-MRA扫描,评价两种检查方法的图像质量,并以CE-MRA为参照标准,计算QISS MRA诊断下肢动脉显著性狭窄(≥50%)的敏感度、特异度、阳性预测值、阴性预测值和诊断准确性,并以配对χ2检验分析两种检查方法对诊断下肢动脉显著性狭窄(≥50%)的差异有无统计学意义,两种检查方法的相关性采用kappa检验。结果:51例中48例成功行QISS-MRA检查,其中图像质量优、良、差者分别为40(78.43%)、8(15.69%)和3例(5.88%)。按血管节段计算,QISS-MRA诊断下肢动脉显著性狭窄的敏感度和特异度分别为90.15%和98.87%,阳性预测值和阴性预测值分别为96.75%和96.42%,总体符合率为95.91%。对于下肢动脉显著性狭窄的诊断,QISS-MRA与CE-MRA的差异无统计学意义(χ2=3.76,P>0.05),且两种检查方法具有极好的相关性(r值为0.950,P<0.001)。结论:QISS-MRA检查成功率较高、图像质量良好并且诊断效果接近CE-MRA,对诊断下肢动脉闭塞性病变有一定的临床应用潜力。Objective：To evaluate the value of non-contrast-enhanced MR angiography using quiescent-interval single- shot （QISS） technique in the diagnosis of lower extremity peripheral arterial disease. Methods： Fifty-one patients with pe- ripheral arterial disease in lower extremity underwent QISS-MRA and contrast-enhanced MRA （CE-MRA） examinations. Imaging quality and diagnostic accuracy of QISS-MRA for detecting significant artery stenosis （≥50% or occlusion） were assessed using CE-MRA as a standard reference. Paired χ2 test was used to analyze the difference of diagnostic accuracy be- tween CE MRA and QISS-MRA. Cohen＇s kappa was used to assess agreement between the two methods in the diagnosis of significant artery stenosis. Results.. Forty-eight patients had successfully undergone QISS-MRA and 486 arterial segments had diagnosable image quality. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of QISS-MRA for detecting significant stenosis were 90. 15 %, 98.87 %, 96. 75 %, 96.42 % and 95. 91 %, respectively. There was no significant difference between the two methods （χ2 ： 3.76,P〉0.05）. The interacter reliability of the two methods was very good （r value=0. 950 ,P〈0. 001）. Conclusion： High success rate and reliable image quality were demonstrated by QISS-MRA. It had equivalent diagnostic accuracy for detecting significant artery stenosis in comparison with CE-MRA and may be a potential clinical technique for the evaluation of lower-extremity arterial disease.

关 键 词：磁共振血管成像 下肢 动脉病变 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.5[医药卫生—诊断学]