高分辨磁共振成像与CT血管成像评价颅内动脉粥样硬化斑块的对比研究  

Comparative study of high-resolution MRI and CTA in evaluation of intracranial atherosclerotic plaques

作　　者：常存 王禄伟[1] 王云玲[1] 贾琳[1] 贾文霄[1] CHANG Cun;WANG Luwei;WANG Yunling;JIA Lin;JIA Wenxiao(Imaging Center ,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830000 ,China)

机构地区：[1]新疆医科大学第二附属医院影像中心,新疆乌鲁木齐830000

出　　处：《实用放射学杂志》2019年第5期685-688,707,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81860301);新疆维吾尔自治区科技支疆项目(2018E02063)。

摘　　要：目的探讨高分辨磁共振成像(HR-MRI)及CTA技术对颅内动脉粥样硬化斑块的诊断价值。方法选取27例同时具有HR-MRI及CTA资料的患者,对比分析HR-MRI及CTA对粥样硬化斑块类型的判断结果。结果(1)在59段有病变的血管中,CTA判断粥样硬化斑块或狭窄共120处,HR-MRI判断粥样硬化斑块共108处。2种检查技术共判断斑块122处,有78处两者对斑块类型的判断一致,包括43处钙化斑块,14处混合斑块,21处非钙化斑块。44处两者对斑块类型的判断欠一致,其中27处在CTA显示为管腔的局限性狭窄,HR-MRI则显示为非钙化斑块;14处CTA判断为钙化斑块,HR-MRI则判断困难;2处HR-MRI判断为非钙化斑块,CTA则显示正常;1处CTA判断为混合斑块,HR-MRI判断为非钙化斑块。(2)2种检查方法对不同斑块的显示情况有差异(P<0.001);CTA对于钙化斑块的显示有优势,HR-MRI对于非钙化斑块的显示有优势(调整后标准化残差>3)。结论3.0THR-MRI对非钙化斑块有很好地识别能力,CTA对钙化成分具有独特的优势,两者相互补充,能够提高动脉粥样硬化斑块的检出。Objective To investigate the diagnostic value of high-resolution magnetic resonance imaging(HR-MRI)and CTA in intracranial arterial wall plaques.Methods 27 patients with both HR-MRI and CTA data were enrolled.The results of HR-MRI and CTA diagnosis on atherosclerotic plaques types were compared and analyzed.Results(1)In 59 segments of blood vessels with lesions,120atherosclerotic plaques or stenoses were identified by CTA and 108 atherosclerotic plaques by HR-MRI.Total 122 plaques were identified by both techniques,and 78 plaques were consistent on both techniques,including 43 calcified plaques,14 mixed plaques and 21non calcified plaques.The diagnosis results of HR MRI and CTA were not consistent in 44 plaqucs:27 stenoscs identified by CTA were shown as non-calcified plaques on HR-MRI;14 calcified plaques identified by CTA were difficult to be judged on HR-MRI;2non-calcified plaques identified by HR-MRI were present as normal on CTA;one mixed plaque identified by CTA was diagnosed as non-calcified plaque by HR-MRI.(2)There were differences in showing plaque patterns between the two methods(P<0.001);CTA had an advantage in showing calcified plaques,while HR-MRI had an advantage over non-calcified plaques(adjusted standardized residual was greater than three).Conclusion 3.0T HR-MRI has a good ability to detect non-calcified plaques,while CTA has a unique advantage to detect calcified plaques.Two techniques complementing each other can improve the detection of atherosclerotic plaques.

关 键 词：高分辨磁共振成像 CT血管造影 粥样硬化斑块 

分 类 号：R445.2[医药卫生—影像医学与核医学] R814.43[医药卫生—诊断学]