摘要
目的探讨在3.0T MRI联合低浓度对比剂增强磁共振血管成像(CE-MRA)和动态磁敏感灌注成像(DSCPWI)在急性缺血性脑卒中的应用价值。方法收集南京市第一医院2017年10月～2018年3月急性脑卒中患者30例,所有患者均接受低浓度对比剂CE-MRA和DSC-PWI成像,并于24 h内接受数字减影血管造影(DSA)检查。CE-MRA和DSC-PWI均使用半剂量对比剂浓度(0.05 mmol/kg)。通过与DSA对照,评估CE-MRA对血管狭窄诊断的准确性。CE-MRA诊断血管狭窄及DSC-PWI诊断不匹配区的观察者间一致性检验使用Kappa分析。结果 CE-MRA对头颈动脉低级别(<50%)及高级别(>50%)狭窄诊断的敏感性、特异性、阳性预测值、阴性预测值分别为82.4%、100%、100%、93.8%及100%、82.4%、93.8%、100%。CE-MRA诊断动脉狭窄及DSC-PWI诊断不匹配区观察者之间一致性均好(κ=0.87、0.86)。结论 3.0T MRI联合低浓度对比剂CE-MRA和DSC-PWI是一种可行的急性缺血性脑卒中MRI扫描方案。
Objective To explore application value of low-dose contrast-enhanced MRA (CE-MRA) and dynamic susceptibility contrast perfusion imaging (DSC-PWI) at 3.0T in patients with acute ischemic stroke. Methods Thirty patients with acute ischemic stroke in Nanjing First Hospital from October 2017 to March 2018 were enrolled. All the patients underwent low-dose CE-MRA and DSC-PWI examination, and DSA examination was performed within 24 h. Half-dose contrast agent concentration (0.05 mmol/kg) was used in both CE-MRA and DSC-PWI. The accuracy of CE-MRA in the diagnosis of arterial stenosis was evaluated by comparing with DSA. Inter-observer agreement tests for diagnosis of arterial stenosis with CE-MRA and mismatched areas with DSC-PWI were tested by Kappa analysis. Results The sensitivity, specificity, positive predictive value and negative predictive value of CE-MRA in the diaognosis of low grade (<50%) and high grade (>50%) arterial stenosis of the intracranial and cervical arteries were 82.4%, 100%, 100%, 93.8%, 100% and 82.4%, 93.8%, 100%, respectively. The inter-observer agreements in the diagnosis of arterial stenosis with CE-MRA and mismatch area with DSC-PWI were both excellent (κ= 0.87, 0.86). Conclusion Low-dose CE-MRA and DSC-PWI combination at 3.0T MRI is a feasible MRI scanning protocal for patinets with acute ischemic stroke.
作者
姜海龙
毛存南
陈谦
陈国中
殷信道
JIANG Hailong;MAO Cunnan;CHEN Qian;CHEN Guozhong;YIN Xindao(Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing First Hospital, Jiangsu Province, Nanjing 210006, China)
出处
《中国医药导报》
CAS
2019年第10期150-153,共4页
China Medical Herald
关键词
急性缺血性脑卒中
磁共振成像
钆对比剂
头颈动脉
Acute ischemic stroke
Magnetic resonance imaging
Gadolinium contrast agents
Intracranial and cervical arteries
