3.0T MR多技术联合诊断在头颈部动脉血管狭窄病变中的应用意义  

Application Significance of 3.0T MR Multi-technique in the Diagnosis of Head and Neck Artery Stenosis

作　　者：彭明明 潘智荣 PENG Ming-ming;PAN Zhi-rong(Department of Imaging,The Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital),Guangdong 511518,China)

机构地区：[1]广州医科大学附属第六医院(清远市人民医院)影像科,广东511518

出　　处：《影像技术》2023年第6期13-16,21,共5页Image Technology

摘　　要：目的:探讨3.0T MR 3D TOF MRA、CE MRA,以及T2WI进行头颈总动脉管腔内血管成像,评价其对头颈总动脉管腔内血管成像在头颈总动脉管腔内狭窄病变中的作用与诊断价值。方法:选取我院在2021年1月至2023年4月期间曾接受3D TOF MRA检查的患者117例,其中43例进行头颈CE MRA检查,74例同时进行颈内动脉分叉的T2WI血管壁黑血成像。分别采用3D TOF MRA、CE MRA,对两种技术所完成图像中的脑血管、颈内动脉虹吸段、椎动脉起始部、颈动脉分叉部等多个部位动脉血管狭窄的数目进行统计,并对两种技术的诊断结果进行Kappa一致性检验。分别进行TOF MRA与T2WI颈部总动脉分支处的黑血显像,计算两组之间的病变数目,并进行F检验,以确定是否存在具有统计学意义的差异。结果:行头颈部TOF MRA和CE MRA患者组,各部位诊断结果Kappa值为:大脑前动脉A1段0.711,大脑后动脉P2段0.677,大脑中动脉M1段0.824,颈内动脉虹吸段0.733,颈动脉分叉部0.635,椎动脉起点部0.707。头颈部TOF MRA检查与应用于颈总动脉分支的T2WI检查的黑血型血管壁显像,二者之间的比较值为1.12,P>0.05。结论:3D TOF MRA和CE MRA都能对绝大部分的头颈部动脉血管狭窄病变做出准确判断,但各自存在着不同程度的缺陷。颈动脉血管壁黑血影像能够对是否存在粥样硬化斑块进行准确判断,是一种与头颈部MRA成像相配合的辅助手段。这三种技术的正确使用和组合,能够在多个层面上实现对头颈部血管狭窄性病变的诊断,建议临床应用时根据实际情况选择。Objective:To explore the role and diagnostic value of 3.0TMR 3D TOF MRA,CE MRA,and T2WI in endovascular imaging of common carotid artery in endovascular stenosis of common carotid artery.Methods:The technique used in this study was introduced to patients carefully and plainly,and informed consent was obtained.From January 2021 to April 2023,117 patients in our hospital who had received 3D TOF MRA examination were selected,among which 43 patients underwent head and neck CE MRA examination,and 74 patients underwent T2WI vascular wall black blood imaging of internal carotid artery bifurcation at the same time.3D TOF MRA and CE MRA were used respectively to make statistics on the number of arterial stenosis in the cerebral vessels,internal carotid artery siphon segment,vertebral artery initiation,carotid artery bifurcation in the images completed by the two technologies,and Kappa consistency test was conducted for the diagnostic results of the two technologies.Dark blood imaging of the common cervical artery branches on TOF MRA and T2WI was performed,the number of lesions between the two groups was calculated,and F-test was performed to determine whether there was a statistically significant difference.Results:For the patient group who underwent head and neck TOF MRA and CE MRA,the Kappa values of diagnosis results of each part were as follows:A1 segment of anterior cerebral artery was 0.711,P2 segment of posterior cerebral artery was 0.677,M1 segment of middle cerebral artery was 0.824,siphon segment of internal carotid artery was 0.733,bifurcation segment of carotid artery was 0.635,and origin segment of vertebral artery was 0.707.The comparison black blood group vascular wall imaging between TOF MRA examination of head and neck and T2WI examination of common carotid artery branch was 1.12,P>0.05.Conclusion:Both 3D TOF MRA and CE MRA can accurately judge the majority of head and neck artery vascular stenosis lesions,but they both have different degrees of defects.Carotid wall black blood imaging can accurately judg

关 键 词：头颈部动脉血管狭窄病变 磁共振血管成像 诊断效果 

分 类 号：R445.2[医药卫生—影像医学与核医学]