多期相超短回波四维MRA在评估颅内血管狭窄中的应用价值  

Aplication value of multiphase ultrashort echo four-dimensional MRA in evaluating intracranial vascular stenosis

作　　者：吉善创[1] 李文美[1] 韦明晖 李向荣[1] 秦宇红[1] 韦启君[1] 陈振涛 贾昌凯 杨燕灵 JI Shan-chuang;LI Wen-mei;WEI Ming-hui(Department of Radiology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院放射科,南宁530021 [2]佳能医疗系统(中国)有限公司磁共振事业部临床科研部,天津300162 [3]佳能医疗系统(中国)有限公司磁共振事业部临床应用培训部,北京100016

出　　处：《放射学实践》2022年第1期23-28,共6页Radiologic Practice

摘　　要：目的:探讨多期相超短回波四维磁共振血管成像(mUTE 4D MRA)在评估颅内血管狭窄中的应用价值。方法:前瞻性收集59例脑血管病患者的临床及影像资料,受试者均先行3D时间飞跃法MR血管成像(3D TOF MRA)和mUTE 4D MRA扫描,然后在同一天行CT血管成像(CTA)检查。由2位神经影像医师采用双盲法对血管狭窄情况进行评分(4分法),采用Kruskal-Wallis秩和检验比较3种检查方法的评分情况,采用Dunn’s检验进行3D TOF MRA与mUTE 4D MRA的组间比较,采用组内相关系数(ICC)评估观察者间的一致性以及两种MRA检查方法与CTA评分的一致性。结果:3D TOF MRA、mUTE 4D MRA、CTA在评估手术干预组、颈内动脉、大脑中动脉、大脑后动脉狭窄程度时评分差异有统计学意义(P值均<0.05),且mUTE 4D MRA在评估手术干预组、颈内动脉、大脑中动脉狭窄程度时评分均高于3D TOF MRA(P值均<0.01)。手术干预组3D TOF MRA与CTA评分一致性很差(ICC=0.02),而mUTE 4D MRA与CTA评分一致性极好(ICC=0.88)。3D TOF MRA与CTA在评估颈内动脉(ICC=0.54)、大脑中动脉(ICC=0.53)时一致性中等,在评估大脑前动脉(ICC=0.75)、大脑后动脉(ICC=0.74)、椎动脉(ICC=0.66)时一致性较好;mUTE 4D MRA与CTA在评估颈内动脉(ICC=0.92)、大脑前动脉(ICC=0.88)、大脑中动脉(ICC=0.90)、大脑后动脉(ICC=0.88)、椎动脉(ICC=0.87)时一致性极好。结论:与3D TOF-MRA相比,mUTE 4D MRA可更好地显示颅内血管狭窄情况;以CTA为参考标准,mUTE 4D MRA较3D TOF-MRA与CTA有更好的一致性。Objective:To explore the value of multiphase ultrashort echo four-dimensional(mUTE 4 D) MRA in evaluating intracranial vascular stenosis.Methods:Clinical and imaging data of 59 patients with cerebrovascular disease were prospectively collected.All subjects underwent 3 D TOF MRA and mUTE 4 D MRA scan, and then CTA scan was performed on the same day.The vascular stenosis(4-point method) were independently double-blindly scored by 2 neuroimaging radiologists.The Kruskal-Wallis rank test was used to compare the scores of the three methods, and the Dunn’s test was used to compare 3 D TOF MRA and mUTE 4 D MRA between groups.Intra-group correlation coefficient(ICC) test was used to evaluate the consistency between observers, and the consistency between the two MRA methods and CTA scores.Results:The three methods had significant differences in evaluating the degree of stenosis of the surgical intervention(SI) group, internal carotid artery(ICA),middle cerebral artery(MCA),and posterior cerebral artery(PCA)(all P<0.05),and mUTE 4 D MRA had higher scores than 3 D TOF MRA in evaluating the stenosis of the SI group, ICA and MCA(P<0.01).The consistency between 3 D TOF MRA and CTA scores in the SI group was very poor(ICC=0.02),while the consistency between mUTE 4 D MRA and CTA scores was excellent(ICC=0.88).3 D TOF MRA and CTA had moderate consistency in the evaluation of ICA(ICC=0.54) and MCA(ICC=0.53),and had good consistency in the assessment of ACA(ICC=0.75),PCA(ICC=0.74),and vertebral artery(ICC=0.66).mUTE 4 D MRA was in excellent agreement with CTA in the evaluation of ICA(ICC=0.92),ACA(ICC=0.88),MCA(ICC=0.90),PCA(ICC=0.88) and vertebral artery(ICC=0.87).Conclusion:Compared with 3 D TOF-MRA,mUTE 4 D MRA is better in displaying intracranial vascular stenosis.Taking CTA as a reference, mUTE 4 D MRA is of better consistency than that of 3 D TOF-MRA.

关 键 词：磁共振成像 体层摄影术 X线计算机 血管造影 超短回波 颅内血管 血管狭窄 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]