零回波时间动脉自旋标记及时间飞跃法MR血管成像诊断颅内动脉粥样硬化性狭窄  

MR angiography with zero time echo arterial spin labeling and time of flight methods for diagnosis of intracranial atherosclerotic stenosis

作　　者：吴明振 亓立峰[2] 赵立新[1] 栾继昕 郭田田 时传迎 范华 张传臣[1] WU Mingzhen;QI Lifeng;ZHAO Lixin;LUAN Jixin;GUO Tiantian;SHI Chuanying;FAN Hua;ZHANG Chuanchen(Department of Radiology,Liaocheng People's Hospital,Liaocheng 252000,China;Department of Neurology,Liaocheng People's Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院影像科,山东聊城252000 [2]聊城市人民医院神经内科,山东聊城252000

出　　处：《中国医学影像技术》2022年第3期341-345,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的 观察零回波时间(ZTE)动脉自旋标记(ASL)MR血管成像(MRA)与时间飞跃法(TOF)MRA(TOF-MRA)诊断颅内动脉粥样硬化性狭窄(ICAS)的价值。方法 对25例临床疑诊脑卒中患者行TOF-MRA及ZTE ASL-MRA,并于2天内行DSA检查。采用26段法评价MRA所示颅内动脉图像质量及颅内大、中动脉节段的狭窄程度;以DSA为金标准,比较2种MRA图像质量评分的差异,评估其评价大中动脉狭窄的一致性;绘制MRA诊断血管狭窄率>50%的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),并比较其差异。结果 共25例、625段动脉纳入研究,包括273段大、中动脉及352段小动脉。ZTE ASL-MRA总体图像质量评分[3(2,3)]与TOF-MRA[3(2,3)]差异无统计学意义RDRTLG(Z=-0.57,P=0.57),而前者大、中动脉图像质量评分[3(3,3)]高于后者[3(3,3),Z=-2.10,P=0.04]。ZTE ASL-MRA共诊断271段大、中动脉狭窄,其诊断动脉狭窄>50%的AUC[0.96,95%CI(0.93,0.98)]高于TOF-MRA[0.94,95%CI(0.90,0.96),Z=2.78,P=0.01]。结论 ZTE ASL-MRA显示颅内大、中动脉图像质量及诊断其狭窄的准确性均优于TOF-MRA。Objective To explore the value of zero time echo(ZTE) arterial spin labeling(ASL) MR angiography(MRA) and time of flight(TOF) MRA(TOF-MRA) in diagnosis of intracranial atherosclerotic stenosis(ICAS). Methods Twenty-five patients with clinical suspected stroke underwent TOF-MRA and ZTE ASL-MRA, and then received DSA within 2 days. The imaging quality, and the stenosis degrees of large and medium intracranial arterial segments were evaluated using 26-segment method. The image quality scores of MRA with 2 methods were compared, the consistency of MRA in evaluation on large and medium arteries stenosis were analyzed. Taken DSA results as the gold standards, the receiver operating characteristic(ROC) curves of MRA for diagnosing >50% stenosis were drawn, and the areas under the curve(AUC) were calculated and compared. Results Totally 625 segments in 25 patients were evaluated, including 273 large and medium-sized arterial segments and 352 small-sized arterial segments. No significant difference of imaging quality scores as found between ZTE ASL-MRA(3 [2, 3]) and TOF-MRA(3 [2, 3], Z=-0.57, P=0.57), while imaging quality of the large and medium-sized intracranial arteries on ZTE ASL-MRA(3 [3, 3]) was higher on TOF-MRA(3 [3, 3], Z=-2.10, P=0.04). ZTE ASL-MRA diagnosed stenosis in 271 segments of large and medium-sized arteries, the AUC(0.96, 95%CI [0.93, 0.98]) of ZTE ASL-MRA for diagnosing >50% stenosis was higher than that of TOF-MRA(0.94, 95%CI [0.90, 0.96], Z=2.78, P=0.01). Conclusion ZTE ASL-MRA was superior to TOF-MRA in imaging quality and diagnostic accuracy of large and medium-sized intracranial arteries stenosis.

关 键 词：脑动脉疾病 卒中 动脉粥样硬化 磁共振血管造影术 零回波时间动脉自旋标记 

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