MR二维时间飞跃法、三维梯度毁损回波序列及时间分辨对比剂动态显像诊断颅内静脉窦血栓  

MR two-dimensional time-of-flight,three-dimensional spoil gradient recall and time-resolved imaging of contrast kinetics for diagnosing cerebral venous sinus thrombosis

作　　者：苏鑫[1] 李育 蔡赛男[1] 冯凡滋 刘沁如 刘凡[3] 刘军[1] SU Xin;LI Yu;CAI Sainan;FENG Fanzi;LIU Qinru;LIU Fan;LIU Jun(Department of Radiology,the Second Xiangya Hospital of Central South University,Changsha 410000,China;Department of Radiology,the Forth Hospital of Changsha,Changsha 410000,China;Department of Radiology,Xiangya Hospital Central South University,Changsha 410000,China;Department of Radiology,The First People's Hospital of Longquanyi District,Chengdu West China Longquan Hospital Sichuang University,Chengdu 610100,China)

机构地区：[1]中南大学湘雅二医院放射科,湖南长沙410000 [2]长沙第四医院放射科,湖南长沙410000 [3]中南大学湘雅医院放射科,湖南长沙410000 [4]成都市龙泉驿区第一人民医院华西大学华西医院龙泉医院放射科,四川成都610100

出　　处：《中国医学影像技术》2022年第12期1786-1790,共5页Chinese Journal of Medical Imaging Technology

基　　金：湖南省科技创新计划资助项目(2021RC4016)。

摘　　要：目的观察MR二维时间飞跃法(2D-TOF)、三维梯度毁损回波序列(3D-SPGR)及时间分辨对比剂动态显像(TRICKS)诊断颅内静脉窦血栓(CVST)的价值。方法前瞻性纳入38例疑诊脑静脉血栓患者,对其行MR 2D-TOF、3D-SPGR、TRIKS及数字减影血管造影(DSA)检查;以DSA为金标准,观察3种MR序列显示颅内静脉窦的能力,评估其诊断CVST的效能。结果38例中,9例MRI及DSA均诊断CVST、29例MRI及DSA均提示无CVST。3D-SPGR及TRICK序列图像均可显示上矢状窦、下矢状窦、双侧横窦、双侧乙状窦、直窦及窦汇,且二者对上矢状窦、双侧横窦及左侧乙状窦的显示率均明显高于2D-TOF(P均<0.05)。2D-TOF诊断CVST的效能低于DSA(P=0.025),而3D-SPGR及TRICKS诊断CVST的效能与DSA无明显差异(P=0.34、0.26);2D-TOF、3D-SPRG和TRICKS诊断CVST与DSA的一致性分别为中等、极高和高(Kappa=0.570、0.917、0.788),其诊断CVST的曲线下面积分别为0.716、0.910及0.841。结论3D-SPGR诊断CVST的效能可媲美DSA而优于2D-TOF和TRICKS。Objective To explore the value of MR two-dimensional time-of-flight(2D-TOF),three-dimensional spoil gradient recall(3D-SPGR)and time-resolved imaging of contrast kinetics(TRICKS)for diagnosing cerebral venous sinus thrombosis(CVST).Methods Totally 38 patients with suspected cerebral venous thrombosis were prospectively enrolled.MR 2D-TOF,3D-SPGR,TRICKS and digital subtraction angiography(DSA)were performed.Taken DSA as golden standard,the abilities of 3 MR sequences for displaying intracranial venous sinuses were observed,and the efficacies of 3 MR sequences for diagnosing CVST were evaluated.Results Among 38 patients,with both MRI and DSA,9 patients were found with CVST,while 29 cases were found without CVST.The superior sagittal sinus,inferior sagittal sinus,bilateral transverse sinus,bilateral sigmoid sinus,straight sinus and sinus confluence could be observed on 3D-SPGR and TRICKS sequence images,and the display rates of superior sagittal sinus,bilateral transverse sinus and left sigmoid sinus on 3D-SPGR and TRICKS sequence images were all significantly higher than that on 2D-TOF images(all P<0.05).The efficacy of 2D-TOF for diagnosing CVST was lower than that of DSA(P=0.025),while no significant difference of efficacy for diagnosing CVST was found between 3D-SPGR and DSA(P=0.34),nor between TRICKS and DSA(P=0.26).The consistency of 2D-TOF,3D-SPRG and TRICKS with DSA for diagnosing CVST was moderate,extremely high and high,respectively(Kappa=0.570,0.917,0.788),and the area under the curve of 2D-TOF,3D-SPGR and TRICKS for diagnosing CVST was 0.716,0.910 and 0.841,respectively.Conclusion The efficacy of 3D-SPGR for diagnosing CVST was comparable to DSA and superior to that of 2D-TOF and TRICKS.

关 键 词：静脉窦血栓形成 颅内 磁共振成像 前瞻性研究 

分 类 号：R543.6[医药卫生—心血管疾病] R445.2[医药卫生—内科学]