三维动脉自旋标记原始图像高信号血管征评估颅内动脉闭塞的价值  

Role of bright vessel sign on raw three dimensional arterial spin labeling image in evaluating occlusion of intracranial artery

作　　者：徐志华[1] 杨本强[1] 段阳[1] 

机构地区：[1]解放军沈阳军区总医院放射科,110016

出　　处：《中华神经科杂志》2017年第5期354-357,共4页Chinese Journal of Neurology

基　　金：辽宁省自然科学基金资助项目（201602768）

摘　　要：目的 探讨急性脑梗死患者中出现三维动脉自旋标记（3D ASL）原始图像高信号血管征（BVS）与颅内动脉闭塞之间的关系.方法 收集2016年1-11月于我院就诊的临床高度怀疑为急性脑梗死的患者122例,入院24 h内行DWI、3D ASL及MRA序列检查.分析患者是否存在DWI弥散受限、3D ASL 原始图像BVS征、MRA是否可见颅内动脉闭塞.评估3D ASL原始图像BVS预测颅内动脉闭塞的敏感度、特异度、阳性预测值及阴性预测值,同时分析BVS与MRA预测颅内动脉闭塞间的一致性.结果 通过3D ASL原始图像BVS检测颅内动脉闭塞的敏感度、特异度、阳性预测值和阴性预测值分别为83%、99%、95%和96%. BVS与MRA检测颅内动脉闭塞具有高度一致性（κ=0.86,P〈0.01）.结论 3D ASL原始图像BVS检测颅内动脉闭塞具有较高的敏感度和特异度,与MRA预测颅内动脉闭塞具有高度一致性.Objective To explore the role of bright vessel sign （BVS） on raw three dimensional arterial spin labeling （3D ASL） image in evaluating occlusion of intracranial artery. Methods One hundred and twenty-two patients who were highly suspected of acute cerebral infarction were enrolled and analyzed. All patients were performed magnetic resonance scan with diffusion weighted image （DWI）, 3D ASL and magnetic resonance angiography （MRA） sequences within 24 hours after admission. The presence or absence of restricted lesion on DWI, BVS and occlusion of intracrainal artery on MRA was reviewed. The sensitivity, specificity, positive predictive value, negative predictive value of BVS and consistency of BVS and MRA in assessing occlusion of intracranial artery were assessed. Results The sensitivity, specificity, positive predictive value and negative predictive value of BVS in assessing occlusion of intracranial artery were 83%, 99%, 95% and 96%, respectively.And the presence or absence of BVS on ASL was highly consistent with MRA in assessing occlusion of intracranial artery （κ=0.86, P〈0.01）. Conclusion BVS has a good sensitivity and high specificity in identifying occlusion of intracranial artery, and it is highly consistent with MRA.

关 键 词：灌注成像 颅内动脉 脑梗死 磁共振血管成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]