零回波时间MR血管成像在颅内支架植入术后随访中的临床应用  

Clinical application of zero echo time MR angiography in follow-up after intracranial stent implantation

作　　者：赵芝敏 赵卫[1] 李庆福 孟雪柔 卓松波 张晓东 游占亮 王滔[1] ZHAO Zhimin;ZHAO Wei;LI Qingfu;MENG Xuerou;ZHUO Songbo;ZHANG Xiaodong;YOU Zhanliang;WANG Tao(Department of Medical Imaging,the First Afiliated Hospital of Kunming Medical University,Kumming 650032,China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,云南昆明650032

出　　处：《实用放射学杂志》2023年第7期1170-1173,共4页Journal of Practical Radiology

摘　　要：目的 探讨零回波时间磁共振血管成像(ZTE-MRA)技术在评价不同部位以及植入不同支架的颅内动脉瘤介入术后疗效的临床应用价值.方法 收集行颅内支架植入术的38例患者临床资料.每位患者均在术后3~12个月复查且行磁共振血管成像(MRA)检查,与数字减影血管造影(DSA)检查时间间隔≤1周.主观评价:分别由多位专家对动脉瘤闭塞状态及治疗部位的可视化程度进行定性评分.客观评价:利用ImageJ软件记录患者载瘤动脉管腔灰度均值的相对值以进行定量分析,评估支架内的血流信号.结果 在接受检查的36个动脉瘤中,DSA显示动脉瘤完全闭塞29个,不完全闭塞7个.DSA与ZTE-MRA在检测动脉瘤栓塞状态方面具有极高度一致性,Kappa值为0.84;DSA与时间飞跃法磁共振血管成像(TOF MRA)在检测动脉瘤栓塞状态方面具有中度一致性,Kappa值为0.60.ZTE-MRA和TOF MRA在显示治疗部位的可视化程度评分分别为(3.30±0.84)分、(2.25± 0.82)分,差异有统计学意义(Z=-6.19,P<0.05).ZTE-MRA和TOF MRA在载瘤动脉植入支架处生成的载瘤动脉管腔灰度均值的相对值分别为1.44±0.19、1.30±0.14,差异有统计学意义(Z=-3.87,P<0.05).结论 与TOF MRA相比,ZTE-MRA技术在评价动脉瘤闭塞程度及不同部位植入支架的可视化程度方面具有很大优势,且与DSA有极高度一致性.Objective To explore the clinical value of zero echo time magnetic resonance angiography(ZTE-MRA)technique in evaluating the curative effect of interventional therapy for intracranial aneurysms with different sites and different stents.Methods The clinical data of 38 patients who underwent intracranial stent implantation were collected.All patients were admitted to hospital for reexamination 3-12 months after operation,and the interval between magnetic resonance angiography(MRA)and digital subtraction angiography(DSA)was less than 1 week.Subjective evaluation:the degree of visualization of the occlusive state and treatment site of the aneurysm was qualitatively evaluated by a number of experts.Objective evaluation:ImageJ software was used to record the relative value of the mean gray value of the parent artery lumen for quantitative analysis,to evaluate the blood flow signal in the stent.Results Of the 36 aneurysms examined,DSA showed 29 complete occlusion and 7 incomplete occlusion.There was a high consistency between DSA and ZTE-MRA in detecting the embolized state of aneurysms with the Kappa value of 0.84,moderately consistent between DSA and time-of-flight magnetic resonance angiography(TOF MRA)in detecting the embolized state of aneurysms with the Kappa value of 0.60.The visual degree scores of ZTE-MRA and TOF MRA in displaying the treatment site were 3.30±0.84 and 2.25±0.82 respectively,and the difference was statistically significant(Z=-6.19,P<0.05).The relative values of the mean gray level of the parent artery lumen generated by ZTE-MRA and TOF MRA were 1.44±0.19,1.30±0.14 respectively,and the difference was statistically significant(Z=-3.87,P<0.05).Conclusion Compared with TOF MRA,ZTE-MRA has great advantages in evaluating the degree of aneurysm occlusion and the degree of visualization of stents implanted in different parts,and has a high degree of consistencywithDSA.

关 键 词：零回波时间 支架 磁共振血管成像 随访 

分 类 号：R815[医药卫生—放射医学] R445.2[医药卫生—临床医学]