三维动态增强MR血管造影诊断颈动脉狭窄的对比研究  

Comparative Study of Three-Dimensional Dynamic Contrast-Enhanced MR Angiography in the Diagnosis of Carotid Artery Stenosis

作　　者：包娜[1] 蒋涛[1] 翟仁友[1] 姜桦[1] 崔湧[1] 

机构地区：[1]首都医科大学附属朝阳医院放射科,北京100020

出　　处：《中国医学影像技术》2002年第12期1236-1239,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价双倍剂量三维动态增强MR血管造影技术 ( 3DDCE MRA)诊断颈动脉狭窄的准确性。方法　 2 2例怀疑有颈动脉狭窄的病人均接受超声、双倍剂量 3DDCE MRA和DSA检查。动态增强MRA图像采用最大强度投影法(MIP)和多平面投影重组法 (MPR)重建。应用颈总动脉法 (CCM )测量狭窄率。以DSA检查结果为金标准 ,将超声、3DDCE MRA与其对比 ,评价两种方法的敏感性、特异性、诊断准确性、高估和低估狭窄的情况。结果　① 2 2例 44条颈内动脉中 ,DSA诊断 17条为正常 ,2 7条呈不同程度狭窄或闭塞 ,轻度狭窄 2条 ,中度 8条 ,重度 12条 ,闭塞 5条。 3DDCE MRA与DSA诊断一致者为 40条 ( 90 .9% ) ,3条高估 ,1条低估。②以阴性 (正常 )和阳性 (狭窄或闭塞 )为判断点时 ,3DDCE MRA较超声的敏感性、特异性和诊断准确性高 ,分别为 10 0 %、82 .4%、93 .2 %与 96.3 %、5 8.8%、81.8%。③以 70 %狭窄为判断点时 ,3DDCE MRA的敏感性、特异性和诊断准确性更明显优于超声 ,分别为 94.1%、96.3 %、95 .5 %与 64 .7%、88.9%、79.5 %。结论　与超声检查相比 ,3DDCE MRA评价颈动脉狭窄更可靠 ,它是一种更具先进性的无创检查方法。超声和 3DDCE MRA结合使用能够在颈动脉狭窄的筛选、诊断及监测中发挥重要作用。Objective To evaluate the accuracy of double dose 3D DCE MRA in the diagnosis of carotid artery stenosis. Methods Ultrasound, double dose 3D DCE MRA and DSA were performed in 22 patients with clinal suspected carotid artery stenosis. The images of DCE MRA were reprojected with maximum intensity projection (MIP) and mutiplannar projection reconstuction (MPR).The common carotid artery method (CCM) of measurement was used in evaluating carotid artery stenosis. After we compared the findings of US, 3D DCE MRA with DSA as a golden standard, sensitivity, specificity, diagnositic accuracy,overestimation and underestimation were assessed. Results ①Of 22 cases,DSA provided 44 diagnostic judgements: 17 were negative and 27 were positive (mild stenosis 2, moderate stenosis 8, severe stenosis 12, occlusion 5). 3D DCE MRA was in agreement with DSA in 40 (90.9%), with 3 overestimation and 1 underestimation. ②Taking negative and positive cases as a judgement point, 3D DCE MRA showed higher sensitivity, specificity and diagnostic accuracy than ultrasound (100% vs 96.3%,82.4% vs 58.8%,93.2% vs 81.8%, respectively). ③Taking 70% stenosis as the judgement, 3D DCE MRA obviously showed higher sensitivity,specificity and diagnostic accuracy than US (94.1% vs 64.7%,96.3% vs 88.9%,95.5% vs 79.5%, respectively). Conclusion Compared with US, 3D DCE MRA is more accurate in the evaluation of carotid artery stenosis. A combination of US and 3D DCE MRA is of great help in the screening,diagnosing and monitoring of carotid artery stenosis.

关 键 词：三维动态增强MR血管造影 颈动脉狭窄 磁共振血管造影术 

分 类 号：R543.404[医药卫生—心血管疾病]