摘要
目的:评价心电激发非对比增强磁共振血管成像(ETNCE-MRA)在糖尿病患者下肢动脉狭窄性病变的应用价值。方法:对38例有下肢症状的糖尿病患者依次行下肢动脉ETNCE-MRA、CTA和DSA检査。由2名高年资诊断医师分别对CTA和MRA图像质量评分,并对下肢动脉狭窄程度分级评价。采用Wilcoxon检验对CTA和MRA图像质量评分进行,采用Kappa检验评价CTA和MRA诊断下肢动脉狭窄的一致性。以DSA结果为金标准,计算CTA和MRA诊断下肢动脉显著性狭窄的敏感度、特异度和准确率,两者间的比较采用配对X2检验。结果:2名诊断医师对MRA和CTA的图像质量总体评分分别为[(3.55±0.30)分、(3.49±0.28)分]和[(3.53±0.29)分、(3.45±0.34)分],CTA 图像质量评分略高于MRA (P<0.001)。MRA与CTA诊断下肢动脉狭窄程度的一致性良好[Kappa=0.92、0.91(P<0.05)]o CTA与MRA诊断下肢动脉显著性狭窄的敏感度(94.78%和94.12%, 94.78%和94.12%)、特异度(93.86%和91.23%;92.98%和89.47%)和准确率(94.38%和92.88%;94.01%和92.13%)的差异均无统计学意义(P均>0.05)。结论:TRANCE-MRA能够清晰显示下肢动脉病变,可作为糖尿病患者合并肾功能不全及不能使用对比剂时的一种安全可靠的替代检査方法。
Purpose: To explore ECG triggered non-contrast enhanced MRA (ETNCE-MRA) in the assessment of lower extremity arterial diseases in patients with diabetes. Methods: Thirty-eight symptomatic diabetic patients with lower extremity arterial diseases underwent ETNCE-MRA, CTA and DSA examinations. Quality of CTA and MRA images were rated and arterial stenosis was graded by two senior doctors. Image quality was compared between CTA and MRA using a Wilcoxon test. The Kappa test was used to determine inter-modality agreement between CTA and MRA. The sensitivity, specificity and diagnostic accuracy for significant stenosis of lower extremity arteries of CTA and MRA were calculated and compared by chi-square test using DSA as the standard. Results: The overall image quality scores of CTA (3.53±0.29 and 3.45±0.34) were higher than those of MRA (3.55±O.3O and 3.49±0.28)(P<0.001) by two doctors. Inter-modality agreement between MRA and CTA was excellent for assessment of stenosis of lower extremity arteries (Kappa=0.92, 0.91, P<0.05). There were no statistical difference in the sensitivity (94.78% and 94.12%,94.78% and 94.12%), specificity (93.86% and 91.23%, 92.98% and 89.47%) and accuracy (94.38% and 92.88%, 94.01% and 92.13%) for significant stenosis of lower extremity arteries between CTA and MRA (P>0.05). Conclusion: ETNCE?MRA can clearly display lower extremity arterial stenosis, which can be used as a safe and reliable alternative examination for diabetic patients with renal insufficiency or contraindication of contrast agents.
作者
张岚
邢威
吴云虎
朱海云
ZHANG Lan;XING Wei;WU Yun-hu;ZHU Hai-yun
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2019年第3期280-285,共6页
Chinese Computed Medical Imaging
基金
河南省中医药科学研究专项课题(No.2015ZY02014)~~
关键词
磁共振造影术
CT造影术
血管造影术
糖尿病
下肢动脉
Magnetic resonance angiography
Computed tomographic angiography
Digital subtraction angiography
Diabetes
Lower extremity
