高分辨率MRI血管壁成像和超声对鉴别诊断脑卒中患者颈动脉狭窄原因的效果比较  

Comparison of High Resolution MRI Vessel Wall Imaging and Ultrasound in Differential Diagnosis of Causes of Carotid Stenosis in Stroke Patients

作　　者：陈建初 彭明明 孙小会[2] 刘红艳[1] 陈秀娟 Chen Jianchu;Peng Mingming;Sun Xiaohui;Liu Hongyan;Chen Xiujuan(Department of Imaging,The Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital),Qingyuan,Guangdong 511518;Department of Medical Statistics,The Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital),Qingyuan,Guangdong 511518;Department of Neurology,The Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital),Qingyuan,Guangdong 511518)

机构地区：[1]广州医科大学附属第六医院(清远市人民医院)影像科,广东清远511518 [2]广州医科大学附属第六医院(清远市人民医院)医学统计科,广东清远511518 [3]广州医科大学附属第六医院(清远市人民医院)神经内科,广东清远511518

出　　处：《现代医用影像学》2022年第1期22-26,共5页Modern Medical Imageology

基　　金：清远市科技局科技计划项目(2018B017)。

摘　　要：目的:探讨颈动脉高分辨率MRI(HR-MRI)血管壁成像和超声对鉴别诊断脑卒中患者颈动脉狭窄原因的效果。方法:连续纳入2018年06月-2020年12月清远市人民医院神经内科诊断为脑卒中的患者31例,均行颈部辨血管壁HR-MRI检查、超声颈动脉以及数字减影血管造影术(DSA)检查。比较不同检查方式对颈动脉狭窄原因检出情况,并采用Kappa检验分析HR-MRI与DSA、超声与DSA诊断结果的一致性。结果:DSA、超声、HR-MRI对动脉硬化的检出率比较差异无统计学意义(P>0.05)。HR-MRI对动脉夹层的检出率高于超声,差异有统计学意义(P<0.05)。超声检查未见异常占比22.6%,DSA、HR-MRI检查未见异常均为0,差异有统计学意义(P<0.05)。Kappa检验分析显示,HR-MRI诊断颈动脉狭窄原因与DSA的一致性良好(Kappa值=0.669,P<0.05)。超声诊断颈动脉狭窄原因与DSA的一致性较差(Kappa值=0.221,P<0.05)。结论:高分辨率MRI血管壁成像技术对脑卒中患者颈动脉狭窄原因的鉴别诊断效果优于超声,可作为临床诊治补充检查首选方式。Objective:To explore the effect of carotid high-resolution MRI(HR-MRI)vascular wall imaging and ultrasound in the differential diagnosis of the causes of carotid stenosis in stroke patients.Methods:From June 2018 to December 2020,31 patients with stroke diagnosed in the Department of Neurology of Qingyuan people’s hospital were included.All of them underwent HR-MRI examination of neck vascular wall,ultrasonic carotid artery and digital subtraction angiography(DSA).The detection of causes of carotid stenosis by different examination methods was compared.,and the consistency of HR-MRI and DSA,ultrasound and DSA was analyzed by kappa test.Results:There was no significant difference in the detection rate of arteriosclerosis among DSA,ultrasound and HR-MRI(P>0.05).The detection rate of arterial dissection by HR-MRI was higher than that by ultrasound(P<0.05).22.6% of the patients had no abnormality in ultrasound examination.0 of the patients had no abnormality in DSA and HR-MRI,and the difference was statistically significant(P<0.05).Kappa test showed that HR-MRI had good consistency with DSA in the diagnosis of carotid stenosis(Kappa value=0.669,P<0.05).The consistency between ultrasonic diagnosis and DSA was poor(Kappa value=0.221,P<0.05).Conclusion:High resolution MRI vascular wall imaging is better than ultrasound in the differential diagnosis of the causes of carotid stenosis in stroke patients,and can be used as the first choice for clinical examination.

关 键 词：颈动脉狭窄 高分辨率磁共振成像 颈动脉成像 超声 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]