Willis环结构变异的磁共振血管成像研究  

Research on structural variation of the circle of Willis by MRA

作　　者：高强[1] 周海宁 张新炎 Gao Qiang;Zhou Haining;Zhang Xinyan(Department of Radiology,the Affiliated Weihai Second Municipal Hospital of Qingdao University,Shandong 264200,China;不详)

机构地区：[1]青岛大学附属威海市立第二医院放射科,264200 [2]青岛大学附属威海市立第二医院介入科,264200 [3]威海市立医院放射科

出　　处：《实用医学影像杂志》2021年第6期562-565,共4页Journal of Practical Medical Imaging

摘　　要：目的利用高分辨率三维时间飞跃法磁共振血管成像(3D-TOF-MRA)观察Willis环的结构,并以数字减影血管造影(DSA)结果为标准对比其临床效能评价。方法采集137例怀疑有脑血管疾病和近期进行过脑血管造影的患者行3D-TOF-MRA检查,根据Willis环组成,于MRA及DSA图像上对血管进行分型。以DSA结果为标准,分析MRA图像显示各型Willis环的特异度、灵敏度、阳性预测值、阴性预测值、准确度。结果VR、MIP及原始图像联合分析显示Willis环灵敏度为90%~100%,特异度98%~100%,与DSA判定结果具有较高的一致性。MRA图像对于A、C、D、H四型Wills环的灵敏度和阴性预测值均为100%,联合分析显示前交通动脉缺如的特异度、准确度、灵敏度均为100%,与DSA结果高度一致。MRA图像对于显示F型Willis环的灵敏度、特异性、阳性预测值、阴性预测值、准确性均为100%。VR图像对于B、E、G三型Wills环灵敏度和阳性预测值相对较低(85.0%,86.2%,73.8%),MIP可以稍改善(88.3%,89.2%,81.8%),联合分析可以明显提高(95.8%,96.1%,99.0%),但3种方法的特异性、阴性预测值均较高(99.3%~100%)。结论高分辨3D-TOF-MRA判断Willis环结构与DSA具有很高的一致性,MRA图像对于缺如血管敏感,对于管径≥1 mm的血管灵敏而准确,显示纤细血管特异度较高,且为一种完全无创检查,可作为评估Willis环结构变异的首选方法。Objective To observe the structure of Willis ring with high resolution 3D-TOF-MRA,and to compare its clinical efficacy evaluation based on DSA.Methods A total of 137 patients with suspected cerebrovascular disease and who had recently undergone cerebrovascular angiography were collected for 3D-TOF-MRA examination.According to the composition of the circle of Willis,the blood vessels were classified based on MRA and DSA images.With DSA as the standard,analyze the specificity,sensitivity,positive predictive value,negative predictive value,and accuracy of each type of circle of Willis displayed on the MRA image.Results Combined analysis of VR,MIP and original images showed that the sensitivity of circle of Willis was 90%~100%,and the specificity was 98%~100%,which was consistent with DSA.The sensitivity and negative predictive value of MRA images for A,C,D and H types of circle of Willis were 100%.The specificity,accuracy and sensitivity of MRA images without anterior communicating artery were 100%,which were highly consistent with DSA.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were all 100%for detecting F type.The sensitivity and positive predictive value of VR images for B,E,G types of circle of Willis were relatively low(85.0%,86.2%,73.8%),MIP could be slightly improved(88.3%,89.2%,81.8%),combined analysis could significantly improve(95.8%,96.1%,99.0%),but the specificity and negative predictive value of the three methods were high(99.3%~100%).Conclusion The high resolution 3D-TOF-MRA has a high consistency with DSA in judging the structure of Willis ring.MRA images are sensitive to absent vessels,sensitive and accurate for vessels with diameter≥1 mm,and highly specific for displaying slender vessels.It is a completely non-invasive examination and can be used as the preferred method to evaluate the structural variation of Willis ring.

关 键 词：磁共振成像 介入性 血管造影术 数字减影 大脑动脉环 

分 类 号：R445.2[医药卫生—影像医学与核医学]