儿童大脑静脉血栓诊断:3D Brainview T1W黑血序列与3D CE-MRV序列的对比研究  

Diagnosis of cerebral venous thrombosis in children:Comparative study of 3D Brainview T1W black blood sequence and 3D CE-MRV sequence

作　　者：吕艳秋[1] 陶晓娟[1] 程华[1] 尹光恒[1] 胡迪[1] 洪天予 徐慧娟 彭芸[1] LÜ Yanqiu;TAO Xiaojuan;CHENG Hua;YIN Guangheng;HU Di;HONG Tianyu;XU Huijuan;PENG Yun(Department of Radiology,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心/首都医科大学附属北京儿童医院医学影像中心,北京100045

出　　处：《磁共振成像》2022年第2期75-78,共4页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的回顾性评价3D Brainview T1W黑血序列对儿童大脑静脉血栓的诊断价值。材料与方法回顾性分析25名临床症状提示大脑静脉血栓或已被诊断大脑静脉血栓的儿童病例,25名儿童均在3.0 T磁共振仪上扫描3D Brainview T1W黑血序列和三维磁共振增强静脉血管成像序列(3D contrast-enhanced magnetic resonance venography,3D CE-MRV),其中10名儿童还扫描了颅脑常规MRI和相位对比法三维磁共振静脉血管成像(3D magnetic resonance venography,3D MRV)序列。两名高年资神经放射医生独立双盲阅读3D Brainview T1W和3D CE-MRV图像进行大脑静脉血栓诊断,诊断参考标准基于最后的临床诊断。采用Kappa一致性分析评价3D Brainview T1W序列的观察者间一致性。将3D Brainview T1W和3D CE-MRV获得的最终诊断结果与参考标准对比,分别计算3D Brainview T1W和3D CE-MRV序列诊断的敏感度、特异度及95%CI。结果3D Brainview T1W序列具有非常高的观察者间一致性(k=0.95);3D Brainview T1W序列和3D CE-MRV序列诊断的敏感度及特异度分别为97.1%/99.6%和91.4%/99.2%,差异无统计学意义,但3D Brainview T1W可直接观察血栓,提供的血栓细节及诊断信息更多。结论3D Brainview T1W能够直接观察到血栓,在儿童大脑静脉血栓诊断中具有很高的诊断效能。Objective:To retrospectively evaluate the performance of 3D Brainview T1W black blood sequence for diagnosis of cerebral venous thrombosis(CVT)in children.Materials and Methods:This retrospective study included 25 children who had clinical symptoms suggesting CVT or with known CVT with MRIs performed with 3D Brainview T1W and 3D contrast-enhanced(CE)magnetic resonance venography(MRV)sequences on a 3.0 T scanner,and 10 of them also were performed with routine MRI and 3D phase-contrast(PC)MRV.Two neuroradiologists blindly reviewed 3D Brainview T1W and 3D CE-MRV images to obtain a diagnositic outcome for the presence or absence of CVT for each sequence,respectively.Final diagnostic reference standard was based on clinical diagnosis.The inter-observer agreement for the diagnosis of CVT was evaluated by using Kappa analysis for 3D Brainview T1W.Sensitivity/Specificity was used to assess the diagnostic performance of 3D Brainview T1W and 3D CE-MRV against the final diagnostic reference standard.Results:The inter-observer agreement in the diagnosis of CVT was high for 3D Brainview T1W sequence(κ=0.95).The sensitivity/specificity for 3D Brainview T1W and 3D CE-MRV were 97.1%/99.6%and 91.4%/99.2%,respectively.There was no significant difference between 3D Brainview T1W and 3D CE-MRV in the diagnosis of CVT.However,3D Brainview T1W provided more details of thrombi and diagnostic information.Conclusions:3D Brainview T1W showed the excellent performance in the diagnosis of CVT in children.

关 键 词：磁共振成像 静脉窦血栓 大脑静脉血栓 卒中 儿童 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.32[医药卫生—诊断学]