基于HR-MRI、CAD血管壁成像在临床脑动脉夹层分离的诊断价值  

Diagnostic value of vascular wall imaging based on HR-MRI and CAD in clinical cerebral artery dissection

作　　者：李文进 杨贵昌 胡静 曹永泉 LI Wenjin;YANG Guichang;HU Jing;CAO Yongquan(Department of Radiology,Zibo No 1 Hospital,Zibo 255200,P.R.China)

机构地区：[1]山东省淄博市第一医院,山东淄博255200

出　　处：《医学影像学杂志》2018年第11期1782-1785,共4页Journal of Medical Imaging

摘　　要：目的基于高分辨率磁共振(HR-MRI)血管壁成像在脑动脉夹层分离(CAD)的诊断价值研究。方法纳入2016年6月～2017年6月经我院影像科确诊为CAD且采用HR-MRI、CT血管造影(CTA)、磁共振血管造影(MRA)、数字减影血管造影(DSA)检查的16例患者,对比分析上述4种影像技术诊断CAD的诊断价值和检出率。结果 16例患者中检出大脑中动脉夹层分离3例、椎动脉夹层分离6例、颈内动脉夹层分离6例、基底动脉夹层分离1例。经HR-MRI检测显示:双腔征4例、内膜瓣8例、壁内血肿11例、假性动脉瘤2例。16例患者检出CAD共计18处,DSA14处(77. 77%)、CTA6处(33. 33%)、HR-MRI17处(94. 44%) MRA6处(33. 33%),差异显著(X^2=24. 940,P <0. 001),HR-MRI和DSA检出率显著优于MRA和CTA,但DSA与HR-MRI之间无统计学差异(P> 0. 05)。结论临床CAD诊断应用HR-MRI具有较高的检出率,在诊断中HR-MRI属于高敏感性检查方法,此诊断方法值得临床推广应用。Objective To evaluate the diagnostic value of high resolution magnetic resonance （HR-MRI） angiography in cerebral artery dissection （CAD）. Methods Atotal 16 patients with CAD, who were diagnosed by HR-MRT, CT angiography （CAT）, magnetic resonance angilgraphy （MRA）, and digital angiography （DSA） in the image department of our hospital from June 2016 to June 2015, were enrolled in this work. Results Of the 16 patients, there were 3 cases of middle cerebral artery dissection, 6 cases of vertebral artery dissection, 6 cases of dissection of internal carotid artery, and 1 case of basilar artery dissection. HR-MRI examination showed that there were 4 cases of double cavity sign, 8 cases of intimal flap, 11 cases of intramural hematoma, and 2 cases of false aneurysm. 16 cases were detected in a total of 18 CAD, DSA14 （77.77%）, CTA6 （33.33%）, HR-MRI17 （94.44%） MRA6 （33.33%）, with significant difference （ 2=24.940, P 〈0.001）, HR-MRI and DSA detection rate was significantly better than that of MRA and CTA, but no significant difference between DSA and HR-MRI （ P 〉 0.05）. Conclusion The clinical CAD diagnosis using HR-MRI has a high detection rate. In the diagnosis, HR-MRI belongs to the Gao Min perceptual examination method, and this diagnostic method is worthy of clinical application.

关 键 词：磁共振成像 基底动脉 椎动脉夹层 颈内动脉夹层 大脑中动脉 脑血管造影术 X线 磁共振血管造影术 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]