摘要
目的评估3.0T非增强磁共振血管成像(NCE-MRA)诊断下肢动脉狭窄的价值,为临床提供可靠的检查方法。资料与方法 30例拟诊为下肢动脉病变的患者行NCE-MRA检查后接受增强磁共振血管成像(CE-MRA)检查,评价两种检查方法的图像质量,并以CE-MRA为标准,评估NCE-MRA诊断动脉显著性狭窄(≥50%)的准确度,分析两者诊断动脉显著性狭窄(≥50%)的一致性。结果 30例患者成功完成NCE-MRA和CE-MRA检查,NCE-MRA具有诊断价值的动脉节段有532个。小腿段NCE-MRA图像静脉污染较CE-MRA少(Z=4.92,P<0.01),腹盆部、大腿段NCE-MRA图像静脉污染较CE-MRA多(Z=4.58、3.56,P<0.01)。NCEMRA诊断下肢动脉显著性狭窄(≥50%)的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为97.89%、97.69%、97.74%、93.92%、99.22%,两种检查方法诊断下肢动脉显著性狭窄(≥50%)的一致性较好(Kappa=0.94,P<0.05)。结论在显示下肢动脉狭窄方面,NCE-MRA具有与CE-MRA相近的图像质量和诊断准确度,可以作为肾功能不全或不能使用对比剂的患者进行下肢动脉MRA检查的替代方法。
Purpose To evaluate the diagnostic significance of non-contrast enhanced magnetic resonance angiography （NCE-MRA） for lower extremity arterial stenosis on a 3.0T MR scanner, in order to provide a reliable method for clinical application. Materials and Methods Thirty patients with arterial disease in lower extremity underwent NCE-MRA before contrast enhanced magnetic resonance angiography （CE-MRA）. Image quality of the two methods was compared. The diagnostic accuracy for significant stenosis （ ≥50%） of NCE-MRA was assessed using CE-MRA as a golden standard. The consistency of the two methods in diagnosis of significant stenosis （ ≥ 50%） was analyzed. Results All patients successfully underwent both NCE-MRA and CE-MRA examination. There were 532 arterial segments detected by NCE-MRA. In the calf region, venous artifacts presented more frequently on CE-MRA （Z=4.92, P〈0.01）, while in the abdominal and the femoral regions, venous artifacts presented more frequently on NCE-MRA （Z=4.58 and 3.56, P〈0.01）. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NCE-MRA for the diagnosis of significant stenosis （ ≥ 50%） were 97.89%, 97.69%, 97.74%, 93.92% and 99.22%, respectively. There was good agreement （Kappa=0.94, P〈0.05） between the two methods. Conclusion For the imaging of lower extremity arterial stenosis, NCE-MRA shows similar image quality and diagnostic accuracy with CE-MRA, thus can be used as an alternative method for lower extremity arterial stenosis in patients who have renal insufficiency or other contraindication of contrast media.
出处
《中国医学影像学杂志》
CSCD
北大核心
2015年第4期293-297,共5页
Chinese Journal of Medical Imaging
关键词
动脉闭塞性疾病
下肢
磁共振血管造影术
Arterial occlusive diseases
Lower extremity
Magnetic resonance angiography
