摘要
目的探讨3.0 T高分辨率磁共振成像（HR MRI）评估大脑中动脉粥样硬化性狭窄的可信度。方法 2011年2月~2013年12月,对66例经DSA确诊的动脉粥样硬化性MCA M1段中重度狭窄（50%~99%）患者进行HR MRI检查,测定MCA最狭窄处管腔面积（lumen area,LAnarrow）、血管面积（vessel area,VAnarrow）及参考血管LAreference及VAreference,分析MCA斑块分布部位（前壁、后壁、上壁、下壁）;比较2位研究者的定量测量及定性分析结果,对比分析其中一位研究者首次及1个月后的再次分析结果;ICC法分析观察者自身差异及不同观察者间差异。结果 HR MRI测量VAnarrow、VAreference、LAreference具有非常好的组间（ICC 0.801、0.843、0.808）及组内一致性（ICC 0.811、0.916、0.958）;LAnarrow测定结果的一致性一般（ICC 0.584、0.625）,要差于其他3个指标。HR MRI判断有无斑块的一致性非常好（ICC 0.917、0.960）;HR M RI判定MCA不同部位（上壁、下壁、前壁、后壁）斑块的组间（ICC 0.856、0.836、0.791、0.905）、组内（ICC 0.876、0.827、0.825、0.950）一致性较好。结论基于HR MRI的MCA粥样硬化性狭窄定量、定性分析具有较好的可重复性,但对血管最狭窄处的定量分析可信度仍有待提高。
Objective To assess the reproducibility of 3.0 T high-resolution magnetic resonance imaging（HR MRI） for evaluation of atherosclerotic stenosis in the middle cerebral artery（MCA）. Methods From February, 2011 to December, 2013, 66 consecutive patients with MCA- M1 atherosclerotic stenosis（50%- 99%） confirmed by digital subtractive angiography（DSA）received examinations with 3.0 T HR MRI for measurement of the vessel area（VA） and lumen area（LA） at the maximum narrow site（VAnarrowand LAnarrow） and the reference site（VAreferenceand LAreference） as well as the plaque distribution（ventral, dorsal,superior, and inferior）. Two independent readers reviewed all the images and one reader reevaluated these images 4 weeks later. The inter- and intra-observer reproducibility was evaluated using the intraclass correlation coefficient（ICC）. Results The measurements of VAnarrow, VAreference, and LAreferenceusing HR MRI showed excellent inter-（ICC=0.801, 0.843, and 0.808,respectively） and intra-observer reproducibility（ICC=0.811, 0.916, and 0.958, respectively）, but the measurement of LAnarrowhad only moderate inter- and intra-observer reproducibility（ICC=0.584 and 0.625, respectively）. For plaque distribution analysis（ventral, dorsal, superior, and inferior plaques）, HR MRI also showed excellent inter-（ICC=0.856, 0.836, 0.791, and 0.905,respectively） and intra-observer reproducibility（ICC=0.876, 0.827, 0.825, and 0.950, respectively）. Conclusion HR MRI shows good inter- and intra- observer reproducibility in identifying MCA- M1 atherosclerotic plaque distribution and vessel and lumen measurements, but its reliability for lumen area measurement at the maximum narrowing site needs to be improved.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2014年第10期1402-1407,共6页
Journal of Southern Medical University
基金
国家自然科学基金(31370810)
上海市市级医院新兴前沿技术联合攻关项目(SHDC12012103)
上海市卫计委青年基金(20144Y0201)~~
关键词
高分辨率磁共振成像
颅内动脉狭窄
动脉粥样硬化
大脑中动脉
管壁成像
high-resolution magnetic resonance imaging intracranial atherosclerotic arterial stenosis diseases atherosclerosis middle cerebral artery wall imaging
