高分辨率磁共振成像与CT血管造影评价大脑中动脉狭窄和斑块性质的效果对比  

Comparison of effects between high-resolution magnetic resonance imaging and CT angiography for evaluating angiostegnosis and plaque characteristic of middle cerebral artery

作　　者：胡瑞婷[1] 韦武鹏[2] 李雪花[3] 覃冬华[1] 胡瑞光[4] 秦超[5] 

机构地区：[1]广西壮族自治区民族医院神经内二科,南宁市530001 [2]广西壮族自治区民族医院放射科,南宁市530001 [3]广西壮族自治区民族医院急诊科,南宁市530001 [4]广西壮族自治区民族医院老年科,南宁市530001 [5]广西医科大学第一附属医院神经内科,南宁市530021

出　　处：《广西医学》2017年第7期994-997,共4页Guangxi Medical Journal

基　　金：基金项目 广西急诊与医学救援人才小高地(GXJZ201620)

摘　　要：目的比较高分辨率磁共振成像(HR-MRI)与CT血管造影(CTA)对大脑中动脉狭窄和斑块性质的评价效果。方法选取20例经数字减影血管造影(DSA)确诊大脑中动脉狭窄的患者,均行HR-MRI和CTA检查,比较两种方法对大脑中动脉狭窄的诊断效能及对斑块性质的评估效果,并评价两种方法与DSA评价管腔狭窄程度的一致性。结果 DSA显示共24支大脑中动脉发生血管狭窄。CTA与HR-MRI对大脑中动脉狭窄的检出率、诊断大脑中动脉狭窄的灵敏度、特异度及准确性比较,差异均无统计学意义(P>0.05)。在评价血管狭窄程度方面,HR-MRI与DSA呈高度一致性(κ=0.770,P=0.016),CTA与DSA呈中度一致性(κ=0.528,P=0.031)。HR-MRI对大脑中动脉斑块的总检出率及易损斑块、稳定斑块的检出率均高于CTA(P<0.05)。结论 HR-MRI在评估大脑中动脉狭窄和斑块性质方面比CTA更具优势。Objective To compare the effects between high-resolution magnetic resonance imaging（HR-MRI） and CT angiography（CTA） for evaluating the angiostegnosis and plaque characteristic of middle cerebral artery. Methods Twenty patients diagnosed as middle cerebral artery angiostegnosis by digital subtraction angiography（DSA） were selected,and underwent HR-MRI and CTA. The diagnostic efficiency for middle cerebral artery angiostegnosis and evaluation result of plaque characteristics were compared between the two methods.The consistency between the two methods and DSA for evaluating the severity of angiostegnosis was assessed. Results DSA revealed that angiostegnosis was seen in 24 middle cerebral arteries. No significant differences were found in the detection rate,diagnostic sensitivity,specificity or accuracy between CTA and HR-MRI for middle cerebral artery stenosis（P〈0. 05）. For assessing the severity of angiostegnosis,HR-MRI was highly consistent with DSA（κ = 0. 770,P = 0. 016）,while CTA was moderately consistent with DSA（κ = 0. 528,P = 0. 031）.HR-MRI had higher total detection rate for middle cerebral artery plaque and higher detection rates for vulnerable plaque and stable plaque compared to CTA（P〈0. 05）. Conclusion HR-MRI is superior to CTA for evaluating the angiostegnosis and plaque characteristics of middle cerebral arteries.

关 键 词：大脑中动脉 狭窄 斑块性质 高分辨率磁共振 CT血管造影 血管造影成像 

分 类 号：R743.1[医药卫生—神经病学与精神病学]