触发式非对比增强磁共振血管成像诊断下肢静脉曲张价值探讨  

A pilot study on the value of triggered non-contrast enhanced MRI angiography in the diagnosis of varicose veins of lower extremities

作　　者：许团新[1] 刘晓[1] 朱刚明[1] 吴绍腾[1] 刘成康 杨概 叶沛豪 XU Tuanxin;LIU Xiao;ZHU Gangming;WU Shaoteng;LIU Chengkang;YANG Gai;YE Peihao(Department of Radiology,Dongguan Tungwah Hospital,Dongguan 523110,China)

机构地区：[1]东莞东华医院放射科,523110

出　　处：《天津医药》2022年第2期205-209,共5页Tianjin Medical Journal

基　　金：东莞市社会科技发展一般项目(202050715046901)。

摘　　要：目的探讨触发式非对比增强(TRANCE)磁共振血管成像用于诊断下肢静脉曲张(VV)的临床应用价值。方法30例入组的下肢VV患者(41段静脉)行TRANCE磁共振血管成像及多普勒超声(DUS)检查,对下肢VV最明显处信号比值(SR)与管径比值(VDR)行Pearson相关性分析。对2位医生及2周前后的TRANCE影像Likert评分一致性进行评价。以数字减影血管造影(DSA)结果为金标准,评估2种检查方法诊断效能及一致性。结果下肢静脉SR与VDR呈负相关(r=-0.440,P<0.05)。盆腔段较大腿段整体Likert评分降低(P<0.05),大腿段和小腿段差异无统计学意义。2位医生对盆腔段、大腿段及小腿段2周前和2周后的Likert评分以及同一位医生2周前和2周后的Likert评分均具有较好的一致性。TRANCE与DUS诊断41段VV的敏感度分别为94.59%、86.49%,特异度分别为50.00%、75.00%,准确度分别为90.24%、85.37%,两者诊断结果Kappa值为0.617,一致性较好。结论TRANCE磁共振成像用于VV定量分析的诊断效能及与DUS的一致性较好,且影像质量良好,可作为术前辅助检查手段。Objective To investigate the clinical application of triggered non-contrast enhanced(TRANCE)magnetic resonance imaging in varicose veins(VV)of lower extremities.Methods Thirty patients with 41 segments of veins were examined by TRANCE and Doppler ultrasonography(DUS).Pearson correlation analysis was used to analyze the signal ratio(SR)and vessel diameter ratio(VDR)of VV.The Likert score consistency of TRANCE images was evaluated between the two doctors and between before and after 2 weeks.The digital subtraction angiography(DSA)was used as the gold standard,the diagnostic efficiency and consistency of the two inspection methods were evaluated.Results SR was negatively correlated with VDR(r=-0.440,P<0.05).The overall Likert score was lower in the pelvic segment than that of thigh segment(P<0.05),and there was no significant difference in Likert scores between the thigh and calf segments.The two doctors had good consistency in Likert scores of the pelvic,thigh,and calf segments before and after 2 weeks,and the Likert scores elevated by the same doctor before and after 2 weeks.With surgical results as the gold standard,the sensitivity of TRANCE and DUS of41 segments of VV were 94.59%and 86.49%,the specificity were 50.00%and 75.00%,and the accuracy were 90.24%and85.37%,respectively.The diagnostic efficiency kappa value of the two methods was 0.617,indicating good consistency.Conclusion TRANCE can quantitatively analyze the degree of VV and has good image quality in the diagnosis of lower extremity varicose veins,and the diagnostic efficiency is consistent with DUS.It can be used as an important preoperative auxiliary examination method.

关 键 词：静脉曲张 血管造影术 数字减影 超声检查 多普勒 磁共振血管成像 触发式非对比增强磁共振血管成像 

分 类 号：R654.4[医药卫生—外科学] R445.2[医药卫生—临床医学]