磁共振高分辨率血管壁成像对缺血性脑卒中患者颅内动脉狭窄的诊断价值  

Value of high-resolution vessel wall imaging in diagnosing intracranial artery stenosis in patients with ischemic stroke

作　　者：李锋[1] Li Feng(Department of Medical Imaging,Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院医学影像科,新乡453000

出　　处：《中国实用医刊》2024年第20期62-64,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨磁共振高分辨率血管壁成像(HR-VWI)对缺血性脑卒中(CIS)患者颅内动脉狭窄的诊断价值。方法回顾性分析2022年1月至2023年12月新乡市中心医院收治的89例CIS患者的临床资料,所有患者均行数字减影血管造影(DSA)和HR-VWI检查,明确CIS患者颅内动脉狭窄情况及诊断价值;采用Kappa检验验证HR-VWI诊断与DSA金标准的一致性;比较颅内动脉狭窄与未狭窄患者管腔面积(LA)、血管外壁面积(OWA)、血管最狭窄处管壁面积(WAmln)变化。结果89例CIS患者共检出40例颅内动脉狭窄,发生率为44.94%(40/89);HR-VWI诊断CIS患者颅内动脉狭窄的灵敏度为95.00%(38/40)、特异度为97.96%(48/49)、准确度为96.63%(86/89)、阳性预测值为97.44%(38/39)、阴性预测值为96.00%(48/50);Kappa检验显示,HR-VWI诊断与金标准的一致性较高(Kappa=0.932,P<0.001);颅内动脉狭窄患者LA[(0.78±0.14)mm^(2)]低于未狭窄患者[(1.12±0.23)mm^(2)],OWA、WAmln[(7.58±1.16)mm^(2)、(6.89±1.08)mm^(2)]高于未狭窄患者[(6.36±1.02)mm^(2)、(5.39±0.89)mm^(2)],P<0.05。结论HR-VWI诊断CIS患者颅内动脉狭窄的价值高,与金标准高度一致,有助于明确CIS病因,实现针对性治疗。Objective To investigate the value of high-resolution vessel wall imaging(HR-VWI)in diagnosing intracranial artery stenosis in patients with cerebral ischemic stroke(CIS).Methods A retrospective analysis was conducted on the clinical data of 89 CIS patients admitted to Xinxiang Central Hospital from January 2022 to December 2023.All selected patients underwent digital subtraction angiography(DSA)and HR-VWI examinations to clarify the intracranial arterial stenosis and to analyze diagnostic value for CIS patients.Kappa test was used to verify the consistency between HR-VWI diagnosis and DSA(the gold standard).The changes in lumen area(LA),outer wall area(OWA),and the wall area at the narrowest part of the vessel(WAmln)were compared between patients with and without intracranial arterial stenosis.Results A total of 40 cases of intracranial artery stenosis were detected out among the 89 CIS patients,with an incidence of 44.94%(40/89);the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of HR-VWI in diagnosing intracranial artery stenosis in CIS patients were 95.00%(38/40),97.96%(48/49),96.63%(86/89),97.44%(38/39),and 96.00%(48/50),respectively;Kappa test showed highly consisthent between HR-VWI diagnosis and gold standard(Kappa=0.932,P<0.001).The LA of patients with incracranial arterial stenosis was(0.78±0.14)mm^(2),which was lower than that the(1.12±0.23)mm^(2) of stenosis(P<0.05).The OWA and WAmln of patients with incracranial arterial stenosis were(7.58±1.16)mm^(2) and(6.89±1.08)mm^(2),which were higher than the(6.36±1.02)mm^(2) and(5.39±0.89)mm^(2) of patients without incracranial arterial(P<0.05).Conclusions HR-VWI has a high value in diagnosing intracranial artery stenosis in CIS patients,which is highly consistent with the gold standard;therefore,it can help to clarify the etiology of CIS and perform targeted treatment.

关 键 词：缺血性脑卒中 磁共振高分辨率血管壁成像 颅内动脉狭窄 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]