CT血管造影与磁共振血管成像诊断脊髓血管畸形的临床应用  

CT angiography and magnetic resonance angiography visually showing spinal vessels and spinal involvement in diagnosing spinal vascular malformations

作　　者：洪悦[1] 玉苏甫·肉孜 李晓娟 马超[1] 王佳[1] 周豪[1] 陈杰[1] 王艳[1] HONG Yue;YUSUFU·Rouzi;LI Xiaojuan;MA Chao;WANG Jia;ZHOU Hao;CHEN Jie;WANG Yan(Radiological Imaging Center,Xinjiang Uygur Autonomous Region People's Hospital Urumqi,Urumqi 830000,China)

机构地区：[1]新疆维吾尔自治区人民医院放射影像中心,新疆乌鲁木齐830000

出　　处：《分子影像学杂志》2023年第6期1081-1085,共5页Journal of Molecular Imaging

基　　金：新疆维吾尔自治区人民医院院内科研项目(20200410)。

摘　　要：目的 研究CT血管造影(CTA)与磁共振血管成像(MRA)诊断脊髓血管畸形的临床应用。方法 本研究为前瞻性研究,以2020年2月~2022年12月在我院诊断并进行治疗的脊髓血管畸形患者30例作为试验组,另选取30例同期进行椎体MR平扫加增强的无脊髓血管畸形患者作为对照组,对所有入组对象行磁共振对比增强血管造影(CE-MRA)序列以及重建脊髓血管CTA检查。比较CE-MRA序列以及重建脊髓血管CTA检查的诊断一致性,分析CE-MRA序列以及重建脊髓血管CTA检查联合诊断效能。结果 CE-MRA以及CTA检查中硬脊膜动静脉瘘、脊髓动静脉畸形、髓周动静瘘之间的差异无统计学意义(P>0.05),在对瘘口显示情况的分析中,CE-MRA以及CTA检查中对于供血动脉以及瘘口显示情况的差异无统计学意义(P>0.05);CEMRA与金标准的检查一致性较好,Kappa值为0.758;CTA与金标准的检查一致性较好,Kappa值为0.881,CE-MRA以及CTA检查联合诊断的敏感度高于单独检测;ROC曲线分析显示,CE-MRA以及CTA检查联合诊断的曲线下面积高于单独检测(P<0.001)。结论 在对脊髓血管畸形患者的诊断中,CTA以及CE-MRA的联合诊断可显著提升患者的诊断效能,可作为临床诊断的重要依据。Objective To explore the clinical application of CT angiography(CTA)and magnetic resonance angiography(MRA)in the diagnosis of spinal cord vascular malformations.Methods This prospective study included 30 patients with spinal cord vascular malformation diagnosed and treated in our hospital from February 2020 to December 2022 as the experimental group.In addition,30 patients without spinal vascular malformation who underwent vertebra MR Scan plus enhancement were selected as the control group.Contrast enhanced magnetic resonance angiography(CE-MRA)sequence and reconstructed spinal vascular CTA were performed on all enrolled subjects.The diagnostic consistency of CE-MRA sequence and reconstructed spinal vascular CTA was compared,and the combined diagnostic efficacy of CE-MRA sequence and reconstructed spinal vascular CTA was analyzed.Results There was no statistical significance in dural arteriovenous fistula,spinal arteriovenous malformation,and perimedullary arteriovenous fistula in CE-MRA and CTA examination(P>0.05).In the analysis of fistula,there was no statistical significance in the display of supplying artery and fistula in CE-MRA and CTA examination(P>0.05).CE-MRA had a good consistency by compare with the gold standard,with a kappa value of 0.758,and CTA had a good consistency by compare with the gold standard,with a kappa value of 0.881.The sensitivity of CE-MRA and CTA combined diagnosis were significantly higher than that of the single detection.ROC curve analysis showed that the area under the curve of CE-MRA and CTA combined diagnosis was significantly higher than that of single detection(P<0.001).Conclusion In the diagnosis of spinal cord vascular malformations,the combined diagnosis of CTA and CE-MRA can significantly improve the diagnostic efficiency of patients,and can be used as an important basis for clinical diagnosis.

关 键 词：脊髓血管畸形 CT血管造影 磁共振对比增强血管造影 联合诊断 

分 类 号：R744[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学] R816.1