颅颈联合黑血管壁成像技术对颈动脉闭塞病变的诊断价值与DSA的对照研究  

Diagnostic value of joint head and neck vessel wall imaging technique for internal carotid artery occlusion diseases: comparison with DSA

作　　者：汪振佳 于薇[1] 樊昭阳 刘文[1] 卢迷 郑铁晋[4] WANG Zhenjia;YU Wei;FAN Zhaoyang;LIU Wen;LU Mi;ZHENG Tiejin(Department of Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vessel Diseases,Beijing 100029,P.R.China;Biomedical Imaging Research Institute,Cedars-Sinai Medical Center,Los Angeles,CA,90048,USA;Department of Otolaryngology Head and Neck Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vessel Diseases,Beijing 100029,P.R.China;Department of Neurosurgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vessel Diseases,Beijing 100029,P.R.China)

机构地区：[1]首都医科大学附属北京安贞医院医学影像科北京市心肺血管疾病研究所,北京100029 [2]美国Cedars-Sinai医学中心生物医学影像研究所,美国加利福尼亚州90048 [3]首都医科大学附属北京安贞医院耳鼻咽喉头颈外科北京市心肺血管疾病研究所,北京100029 [4]首都医科大学附属北京安贞医院神经外科北京市心肺血管疾病研究所,北京100029

出　　处：《医学影像学杂志》2019年第11期1817-1822,共6页Journal of Medical Imaging

基　　金：北京市自然科学基金联合项目(编号:17L20194);北京市自然科学基金面上项目(编号:7182046)

摘　　要：目的评估3D颅颈联合黑血管壁成像技术(3D T 1-SPACE)对颈动脉闭塞病变的诊断价值。方法回顾性分析47例怀疑颈内动脉闭塞患者的3D T 1-SPACE图像和DSA图像。对3D T 1-SPACE图像进行评分。分别在3D T 1-SPACE和DSA图像中评价病变程度。以DSA为金标准,评价颅颈联合黑血管壁成像技术诊断颈内动脉完全闭塞病变的一致率、灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比和阴性似然比。结果47例患者(男性34例,女性13例)均顺利完成颈内动脉颅内外段全程MR成像。图像质量评分为(3.29±0.94)分。以DSA结果为金标准,3D T 1-SPACE诊断颈内动脉完全闭塞的一致率、灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比与阴性似然比分别为93.6%、97.0%、85.7%、94.1%、92.3%、6.79和0.04。Kappa值为0.84。结论颅颈联合黑血管壁成像技术对颈动脉闭塞病变具有良好的诊断价值,并且能清晰展示颈动脉急、慢性闭塞病变特征。Objective To evaluate the accuracy and application value of joint head and neck vessel wall Imaging technique(3D T 1-SPACE)for the diagnosis of internal carotid artery occlusion diseases.Methods 47 patients were retrospectively evaluated with 3D T 1-SPACE and DSA images.The degree of carotid artery stenosis were obtained from 3D T 1-SPACE and DSA was independently determined.The consistency rate,sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were used to assess the diagnostic ability of 3D T 1-SPACE technique.Results A total of 47 patients(34 men,13 women)received 3D T 1-SPACE scanning and DSA successfully.The consistency rate,sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio of 3D T 1-SPACE in diagnosing internal carotid artery total occlusion were 93.6%,97.0%,85.7%,96.4%,95.5%,90.0%,24.5 and 0.13,respectively.Conclusion 3D T 1-SPACE is a noninvasive and accurate method in diagnosing internal carotid artery total occlusion diseases and can show the characteristics of acute and chronic carotid artery occlusion clearly.

关 键 词：颈内动脉闭塞 磁共振成像 

分 类 号：R543.4[医药卫生—心血管疾病] R445.2[医药卫生—内科学]