TOF MRA结合3D-ASL在脑动脉狭窄及闭塞中的诊断价值  

Diagnostic Value of TOF MRA Combined with 3D-ASL in Cerebral Artery Stenosis and Occlusion

作　　者：李新明 杨得奖[1] 陈小红[1] 程宗新 LI Xin-ming;YANG De-jiang;CHEN Xiao-hong;CHENG Zong-xin(Department of Neurology,Nanchang First Hospital,Nanchang 330008,Jiangxi,China)

机构地区：[1]南昌市第一医院神经内科,江西南昌330008

出　　处：《医学信息》2022年第13期176-178,共3页Journal of Medical Information

基　　金：江西省卫生计生委科技计划(编号:20172861)。

摘　　要：目的研究时间飞跃法磁共振血管成像(TOF MRA)结合三维动脉自旋标记技术(3D-ASL)在脑动脉狭窄及闭塞疾病中的诊断价值。方法选取2018年1月-2020年12月在我院诊治的150例脑动脉狭窄及闭塞疾病患者为研究对象,均采用TOF MRA、3D-ASL成像以及TOF MRA结合3D-ASL技术进行诊断,以数字减影血管造影(DSA)为金标准,比较不同成像技术的诊断效能、诊断不同脑动脉狭窄程度及闭塞的准确率、与DSA诊断结果的一致性以及3D-ASL成像技术下不同标记后延迟(PLD)时间责任颈内动脉供血区与镜像侧脑血流量(CBF)。结果TOF MRA结合3D-ASL成像诊断脑动脉狭窄及闭塞的敏感度、特异度、准确性、阳性预测值、阴性预测值均高于TOF MRA、3D-ASL成像技术(P<0.05);TOF MRA结合3D-ASL诊断成像技术诊断1、2级动脉狭窄的准确率高于TOF MRA、3D-ASL成像技术(P<0.05);三种方法诊断3、4级动脉狭窄及闭塞的准确率比较,差异无统计学意义(P>0.05);TOF MRA结合3D-ASL的准确率与DSA诊断结果具有高度一致性,且一致性高于TOF MRA、3D-ASL单独检测(P<0.05);3D-ASL成像技术下,PLD为1.5 s时,闭塞侧颈内动脉供血区CBF值低于镜像侧(P<0.05),但PLD为2.0 s时,闭塞侧颈内动脉供血区CBF值与镜像侧比较,差异无统计学意义(P>0.05)。结论TOF MRA结合3D-ASL对脑动脉狭窄及闭塞具有较高的诊断价值,可提升血管低狭窄程度的诊断准确率,评估闭塞脑血流灌注情况,两者联合可提高诊断效能,为临床介入治疗提供参考依据。Objective To study the value of time-of-flight magnetic resonance angiography(TOF Mra)combined with three-dimensional arterial spin labeling(3D-ASL)in the diagnosis of cerebral artery stenosis and occlusion.Methods A total of 150 patients with cerebral artery stenosis and occlusion who were treated in our hospital from January 2018 to December 2020 were selected as subjects.TOF MRA,3D-ASL imaging and TOF MRA combined with 3D-ASL technology were used for diagnosis.Digital subtraction angiography(DSA)was used as the gold standard.The diagnostic efficiency of different imaging techniques,the diagnostic accuracy of different degrees of cerebral artery stenosis and occlusion,the consistency with DSA diagnostic results,and the time-responsible internal carotid artery blood flow(CBF)of different post-label delay(PLD)under 3D-ASL imaging techniques were compared.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of TOF MRA combined with 3D-ASL imaging in the diagnosis of cerebral artery stenosis and occlusion were higher than those of TOF MRA and 3D-ASL imaging(P<0.05).The accuracy of TOF MRA combined with 3D-ASL in the diagnosis of grades 1 and 2 arterial stenosis was higher than that of TOF MRA and 3D-ASL(P<0.05).There was no significant difference in the accuracy of three methods in the diagnosis of grades 3 and 4 arterial stenosis and occlusion(P>0.05).The accuracy of TOF MRA combined with 3D-ASL was highly consistent with DSA diagnosis results,and the consistency was higher than that of TOF MRA and 3D-ASL alone(P<0.05).Under 3D-ASL imaging technology,when PLD was 1.5 s,the CBF value of the internal carotid artery blood supply area on the occlusion side was lower than that on the mirror side(P<0.05);however,when PLD was 2.0 s,there was no significant difference in CBF value between the occlusion side and the mirror side(P>0.05).Conclusion TOF MRA combined with 3D-ASL has high diagnostic value for cerebral artery stenosis and occlusion,which can improve the diagnostic

关 键 词：TOF MRA 3D-ASL 脑动脉狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]