非对比增强3D mDixon MR血管成像技术在颈部动脉应用价值的初步探讨  

Preliminary discussion on the application value of non-contrast enhanced 3D mDixon MR angiography technique in carotid artery

作　　者：许团新[1] 刘晓[1] 朱刚明[1] 苏丽兴 陈旭东 苏汶俊 陈德成 漆强[1] XU Tuanxin;LIU Xiao;ZHU Gangming;SU Lixing;CHEN Xudong;SU Wenjun;CHEN Decheng;QI Qiang(Department of Radiology,Dongguan Tungwah Hospital,Dongguan,Guangdong Province 523110,China)

机构地区：[1]东莞东华医院放射科,广东东莞523110

出　　处：《实用放射学杂志》2023年第10期1707-1711,共5页Journal of Practical Radiology

摘　　要：目的探讨非对比增强三维改良Dixon磁共振血管成像(3D mDixon MRA)技术在颈部动脉的临床应用价值。方法对32例颈动脉病变患者分别行3D mDixon MRA及三维时间飞跃法磁共振血管成像(3D TOF MRA)检查,由2位高年资医生采用双盲法、完全随机分别对3D mDixon MRA及3D TOF MRA图像质量评分、信噪比(SNR)及对比噪声比(CNR)测量。采用组内相关系数(ICC)评价2位医生及2周前后对3D mDixon MRA图像Likert评分的一致性,采用配对t检验评估2位医生对2种检查评分的差异性,以及独立样本t检验比较2种检查方法图像SNR和CNR差异。以CT血管成像(CTA)为金标准,评估2种检查的诊断效能及一致性。结果2位医生2周前和2周后的Likert评分以及同一位医生2周前和2周后的Likert评分一致性较好,差异有统计学意义(P<0.05)。3D mDixon MRA 3段主观图像质量平均分、SNR、CNR均高于3D TOF MRA图像,差异有统计学意义(P<0.005)。CTA诊断颈部动脉狭窄患者19例(33处),3D mDixon MRA与3D TOF MRA对颈部动脉狭窄诊断的敏感度分别为94.74%、94.74%,特异度分别为92.86%、78.57%,准确度分别为93.94%、87.88%,两者诊断结果Kappa值为0.50,一致性一般。结论3D mDixon MRA技术在颈部动脉血管中图像质量良好,在一定程度下提高对颈部动脉狭窄程度的判断。Objective To explore the clinical application value of non-contrast enhanced three-dimensional modified Dixon magnetic resonance angiography(3D mDixon MRA)technique in carotid artery.Methods Thirty-two patients of carotid artery disease were evaluated with 3D mDixon MRA and three-dimensional time-of-flight magnetic resonance angiography(3D TOF MRA).The image quality scores,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of 3D mDixon MRA and 3D TOF MRA were measured by two senior doctors in a double-blind and completely random manner respectively.The intraclass correlation coefficient(ICC)was used to evaluate the consistency of the Likert scores on the 3D mDixon MRA images between the two doctors before and after 2 weeks.Paired t-test was used to assess the difference between two physicians’scores of the two examinations,and the independent sample t-test was applied to compare differences between SNR and CNR of images of the two examination methods.Computed tomography angiography(CTA)was used as the gold standard to evaluate the diagnostic performance and consistency of the two examinations.Results The Likert scores of the two doctors before and after 2 weeks were consistent with the Likert scores of the same doctor before and after 2 weeks,and the difference was statistically significant(P<0.05).The average quality score,SNR,and CNR of the three-segment subjective images of 3D mDixon MRA were all higher than those of 3D TOF MRA images,and the difference was statistically significant(P<0.005).In 19 patients(33)with carotid artery stenosis were diagnosed by CTA,the sensitivity of 3D mDixon MRA and 3D TOF MRA for the diagnosis of carotid artery stenosis was 94.74% and 94.74% respectively,and the specificity was 92.86% and 78.57% respectively,and the accuracy was 93.94% and 87.88% respectively.The Kappa value of the two diagnostic results was 0.50,and the consistency was general.Conclusion 3D mDixon MRA technology has good image quality in the carotid arteries,which can improve the judgment of the degree

关 键 词：颈动脉 磁共振血管成像 改良Dixon 时间飞跃法 

分 类 号：R816.1[医药卫生—放射医学] R445.2[医药卫生—临床医学]