高分辨MRI3D黑血技术和CT血管造影对颈动脉狭窄患者斑块特性诊断价值比较  

Diagnostic Value of High-Resolution MRI3D Black Blood and CT Angiography in Diagnosis of Plaque Characteristics in Patients with Carotid Artery Stenosis

作　　者：刘常利 王少斌[2] 张军[1] LIU Chang-li;WANG Shao-bin;ZHANG Jun(Imaging Department of Inner Mongolia Baogang Hospital,Baotou 014010,Inner Mongolia,China;Department of Neurology,Inner Mongolia Baogang Hospital,Baotou 014010,Inner Mongolia,China)

机构地区：[1]内蒙古包钢医院影像科,内蒙古包头014010 [2]内蒙古包钢医院神经内科,内蒙古包头014010

出　　处：《中国CT和MRI杂志》2023年第1期50-52,共3页Chinese Journal of CT and MRI

摘　　要：目的 比较高分辨磁共振成像(MRI)3D黑血技术和计算机断层扫描(CT)血管造影(CTA)对颈动脉狭窄患者斑块特性的诊断价值。方法 选取2020年1月至12月本院收治的68例临床拟诊为颈动脉狭窄伴斑块患者。所有研究对象均进行颈部MRI 3D黑血技术和CTA检查,比较高分辨率MRI 3D黑血与CTA的定量测量结果。以数字减影血管造影(DSA)为金标准,分析两种检测方法对血管狭窄和溃疡斑块的诊断价值。结果 68例患者中单侧病变10例,双侧病变58例,3支因图像质量不佳予以剔除,共纳入123支颈动脉病变。高分辨率MRI 3D黑血测量的管腔面积、管壁面积及管壁外界面积与CTA比较,差异均无统计学意义(P>0.05)。高分辨率MRI 3D黑血、CTA测量管腔狭窄率比较差异无统计学意义(P>0.05),Pearson相关性分析显示高分辨率MRI 3D黑血、CTA与DSA测量管腔狭窄率均呈正相关(P<0.001)。以DSA为金标准,高分辨率MRI 3D黑血检查对血管狭窄>70%的灵敏度为93.88%、特异度为100.00%、约登指数为0.939;CTA的灵敏度为91.83%、特异度为93.24%、约登指数为0.851。高分辨率MRI 3D黑血和CTA分别检出溃疡斑块38个、35个,DSA检出33个,高分辨率MRI 3D黑血诊断溃疡斑块的灵敏度、特异度和约登指数分别为100.00%、91.44%、0.914,CTA诊断溃疡斑块的灵敏度、特异度和约登指数分别为78.79%、90.00%、0.688。结论 高分辨率MRI 3D黑血技术与CTA对颈动脉狭窄均有较高的诊断价值,但高分辨率MRI 3D黑血技术对溃疡斑块的诊断价值更高。Objective To compare the diagnostic value of high-resolution magnetic resonance imaging(MRI) 3D black blood technique and computed tomography(CT) angiography(CTA) in the diagnosis of plaque characteristics in patients with carotid artery stenosis. Methods Sixty eight clinically diagnosed patients with carotid artery stenosis and plaque who were admitted to our hospital from January to December 2020 were selected. All subjects underwent neck MRI 3D black blood technique and CTA examination, and the quantitative measurement results of high-resolution MRI 3D black blood and CTA were compared. With digital subtraction angiography(DSA) as the gold standard, the diagnostic value of two detection methods for vascular stenosis and ulcer plaque was analyzed. Results Among the 68 patients, 10 were unilateral lesions and 58 were bilateral lesions. 3 vessels were removed due to poor image quality. A total of 123 carotid artery lesions were included. There was no significant difference in the area of the lumen, the area of the tube wall and the external area of the tube wall measured by high-resolution MRI 3D black blood compared with CTA(P>0.05). There was no statistically significant difference in the rate of lumen stenosis measured by high-resolution MRI 3D black blood and CTA(P>0.05). Pearson correlation analysis showed that high-resolution MRI 3D black blood and DSA were positively correlated with the luminal stenosis rate measured by DSA(P<0.001). With DSA as the gold standard, the sensitivity of high-resolution MRI 3D black blood examination for vascular stenosis>70% was 93.88%, the specificity was 100.00%, and the Youden index was 0.939. The sensitivity of CTA was 91.83%, the specificity was 93.24%, and the Youden index was 0.851. High-resolution MRI 3D black blood and CTA detected 38 and 35 ulcer plaques, respectively, and DSA detected 33. The sensitivity, specificity and Youden index of high-resolution MRI 3D black blood in the diagnosis of ulcer plaques were respectively 100.00%, 91.44%, 0.914, the sensitivity, spe

关 键 词：高分辨率磁共振成像 3D黑血技术 颈动脉狭窄 斑块特性 诊断 

分 类 号：R543.4[医药卫生—心血管疾病]