磁敏感血管征在显示超急性脑梗死颅内动脉血栓中的应用  

Clinical application of susceptibility vessel sign in monitoring intracranial arterial thrombosis in patients with hyperacute cerebral infarction

作　　者：郑兴友[1] 黄荣慧[1] 许顺驰 李育[1] 喻科 谢军 邓利猛[1] ZHENG Xing-You;HUANG Rong-Hui;XU Shun-Chi;LI Yu;YU Ke;XIE Jun;DENG Li-Meng(Department of Radiology,The Fourth Hospital of Changsha,Changsha,Hunan 410006,China;Department of Interventional Vascular Surgery,The Fourth Hospital of Changsha,Changsha,Hunan 410006,China)

机构地区：[1]湖南省长沙市第四医院医学影像科,湖南长沙410006 [2]湖南省长沙市第四医院介入血管外科,湖南长沙410006

出　　处：《国际神经病学神经外科学杂志》2021年第3期235-238,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨磁敏感加权成像(SWI)技术显示超急性脑梗死颅内动脉血栓的应用价值。方法选取46例发病6 h内的超急性脑梗死患者进行回顾性分析,术前进行头部平扫CT、常规MRI、弥散加权成像、SWI(发病6 h以内),之后进行数字减影血管造影(DSA)检查;分析CT脑动脉高密度征(CHAS)、SWI磁敏感血管征(SVS)诊断动脉血栓的灵敏度、特异度,利用Kappa检验CHAS与SVS之间的一致性。结果 46例患者中DSA证实颅内动脉血栓15例。以DSA为参考标准,CHAS和SVS诊断动脉血栓的灵敏度、特异度、诊断效率、阳性预测值、阴性预测值分别为86.7%(13/15)、93.5%(29/31)、91.3%(42/46)、86.7%(13/15)、93.5%(29/31)和100%(15/15)、93.5%(29/31)、95.7%(44/46)、91.3%(42/46)、100%(29/29),CHAS与SVS诊断动脉血栓一致性较好(k=0.758,P<0.05)。结论 SVS对显示颅内动脉血栓有重要意义,SWI技术可常规用于超急性期脑梗死患者。Objective To investigate the application of susceptibility-weighted imaging(SWI) in the diagnosis of intracranial arterial thrombosis in patients with hyperacute cerebral infarction.Methods A retrospective analysis was performed for 46 patients with hyperacute cerebral infarction within 6 hours after onset.Plain CT scan of the head,conventional magnetic resonance imaging,diffusion-weighted imaging,and SWI were performed within 6 hours after onset,and then digital subtraction angiography(DSA) was performed.Cerebral hyperdense artery sign(CHAS) on CT and susceptibility vessel sign(SVS) on SWI were analyzed in terms of their sensitivity and specificity in the diagnosis of arterial thrombosis,and the Kappa test was used to investigate the consistency between CHAS and SVS.Results Of all 46 patients,15 were diagnosed with cerebral arterial thrombosis by DSA.With DSA as the reference standard,CHAS had a sensitivity of 86.7%(13/15),a specificity of 93.5%(29/31),a diagnostic efficiency of 91.3%(42/46),a positive predictive value of 86.7%(13/15),and a negative predictive value of 93.5%(29/31) in the diagnosis of cerebral arterial thrombosis,while SVS had a sensitivity of100%(15/15),a specificity of 93.5%(29/31),a diagnostic efficiency of 95.7%(44/46),a positive predictive value of91.3%(42/46),and a negative predictive value of 100%(29/29).CHAS and SVS had good consistency in the diagnosis of arterial thrombosis(k=0.758,P <0.05).Conclusions SVS has an important value in displaying cerebral arterial thrombosis,and SWI can be used routinely in patients with hyperacute cerebral infarction.

关 键 词：超急性期脑梗死 磁敏感加权成像 磁敏感血管征 脑动脉高密度征 

分 类 号：R743.3[医药卫生—神经病学与精神病学]