摘要
目的 评价对比剂增强MR血管造影 (CEMRA)与心电门控二维时间飞跃法 (Gated 2DTOF)MRA评价颈内动脉狭窄的准确性。方法 3 4例怀疑有颈内动脉狭窄的病人 (男 2 7例 ,女 7例 ,年龄 45～ 78岁 )均接受了CEMRA、Gated 2DTOFMRA和DSA检查。MRA图像采用最大强度投影法重建后与DSA进行对比。评价两种MRA方法的敏感性、特异性、诊断准确性、高估狭窄和低估狭窄的情况。结果 (1 ) 3 4例 68条颈内动脉中 ,DSA诊断 2 3条为正常 ,45条呈不同程度狭窄或闭塞 ,其中轻度狭窄 1 0条、中度 1 4条、重度 1 7条、闭塞 4条。CEMRA与DSA结果一致者为 66条 (97% ) ,2条高估。Gated 2DTOFMRA与DSA诊断一致者为 56条 (82 % ) ,其中高估 9条 ,低估 3条。 (2 )以正常和狭窄或闭塞为判断点时 ,CEMRA较Gated 2DTOFMRA的敏感性、特异性和诊断准确性高 ,分别为1 0 0 %、1 0 0 %、1 0 0 %与 95 6%、78 3 %、89 4%。 (3 )以 70 %狭窄为判断点时 ,CEMRA与Gated 2DTOFMRA的敏感性、特异性和诊断准确性分别为 1 0 0 %、97 8%、98 5%与 95 2 %、93 6%、94 1 %。Gated 2DTOFMRA与DSA比较的 χ2 =3 0 0 0 ,P =0 0 83 ;CEMRA与DSA比较的 χ2 =2 0 0 0 ,P =0 1 57;而Gated2DTOFMRA与CEMRA比较的 χ2 =1 60 0 ,P =0 2 0 6。
Objective To compare the accuracy of CE MRA and Gated 2D TOF MRA in evaluation of internal carotid artery stenosis. Methods 34 patients (male 27, female 7, age range 45-78 years) were evaluated with contrast enhanced three dimensional magnetic resonance angiography (CE MRA) and unenhanced ECG gated two dimensional time of flight MRA (Gated 2D TOF MRA). Digital subtraction angiography (DSA) was used as the “gold standard”. The MRA images were reprojected with maximum intensity projection (MIP) algorithm. Sensitivity, specificity, diagnositic accuracy,overestimation and underestimation were assessed. Results (1) DSA provided 68 diagnostic judgments: 23 were negatives and 45 were positives (mild stenosis 10, moderate stenosis 14, severe stenosis 17, occlusion 4). CE MRA was in agreement with angiography in 66 (97%), but overestimation resulted in 2 cases. Gated 2D TOF MRA was in agreement with angiography in 56 (82%), with 9 overestimation and 3 underestimation. (2) Taking negative and positive cases as judgement, CE MRA showed higher sensitivity, specificity, and diagnostic accuracy than Gated 2D TOF MRA (100% versus 95 6%, 100% versus 78.3%, 100% versus 89.4%, respectively). (3) Taking 70% stenosis as judgement, CE MRA also showed higher sensitivity, specificity, and diagnostic accuracy than Gated 2D TOF MRA (100% versus 95 2%, 97.8% versus 93.6%, 98.5% versus 94.1%, respectively). Gated 2D TOF MRA vs DSA, CE MRA vs DSA and Gated 2D TOF MRA vs CE MRA all had no significant difference (χ 2=3.000 with P =0.083, χ 2=2.000 with P =0.157, and χ 2=1.600 with P =0.206 respectively) Conclusion Compared with Gated 2D TOF MRA,CE MRA is more accurate in evaluation of carotid artery stenosis.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2001年第9期698-702,共5页
Chinese Journal of Radiology
