摘要
目的 对比性评估静音MRA的图像质量以及诊断效价,探讨静音MRA在颅内动脉瘤病变诊断中的可行性。方法 前瞻性收集2015年12月至2018年12月于江苏省苏北人民医院诊断疑似脑血管病变患者27例,共有动脉瘤病灶32个。所有病例于CTA检查前同日行3.0 T MRI扫描。两名神经放射医师采用双盲法分别对静音MRA及时间飞跃法(TOF)MRA图像质量(信号均匀度、病灶显著性、静脉信号或干扰以及诊断可信度4个方面)进行评估(采用四分法)。定量测量脑动脉瘤瘤体长径值,并根据动脉瘤长径将动脉瘤分为微小动脉瘤组(长径≤3 mm)和较大动脉瘤组(长径>3 mm)。两种MRA图像质量评分差异比较分别采用Wilcoxon秩和检验。采用组内相关系数(ICC)检验分别评估两种MRA与CTA间测量结果的一致性。结果 32个颅内动脉瘤病灶中,静音MRA和TOF MRA图像的信号均匀度分别为3.38±0.49、3.00±0.62,静脉信号/干扰分别为3.77±0.42、2.65±0.48,两者比较差异具有统计学意义(Z=-2.21,P=0.02;Z=-5.69,P=0.01)。静音MRA和TOF MRA图像的病灶显著性分别为3.19±0.56、3.15±0.46,诊断可信度分别为3.27±0.44、3.12±0.51,两者比较差异无统计学意义(P均>0.05)。关于动脉瘤长径的测量,微小动脉瘤组内静音MRA测量结果与CTA结果之间呈极高度一致,ICC (95%可信区间)为0.94(0.82~0.98),TOF MRA测量结果与CTA结果之间呈高度一致,ICC(95%可信区间)为0.72 (0.30~0.91);较大动脉瘤组内,静音MRA、TOF MRA测量结果与CTA结果之间均呈极高度一致,ICC (95%可信区间)分别为0.98 (0.95~0.99)、0.95(0.87~0.98)。结论 与TOF MRA相比,静音MRA可以提供更高的图像质量和准确率,且与CTA具有更高的一致性,有望进一步常规应用于临床。
Objective To evaluate image quality and diagnostic performance of silent MR angiography(MRA)and discuss the feasibility of silent MRA in diagnosing intracranial aneurysms.Methods Twenty seven patients suspected with cerebrovascular disorders and 30 intracranial aneurysms in Northern Jiangsu People's Hospital,were enrolled prospectively in this study from December 2015 to December 2018.Silent and time of flight(TOF)MRA were performed on the same day prior to CTA examination.The corresponding MRA images were independently and blindly evaluated by two experienced neuroradiologists in the aspects of signal homogeneity,lesion conspicuity,venous signal/artifact and diagnostic confidence(4-point scale).The aneurysms were divided into tiny(≤3 mm)and non-tinyaneurysm groups(>3 mm)according to the measured diameters of aneurysms.The differences in image quality ratings between silent MRA and TOF MRA were analyzed using Wilcoxon signed rank tests.Intra-class correlation coefficients(ICC)were used to test the consistency of measurements between MRAs(silent MRA,TOF MRA)and CTA.Results CTA revealed 32 intracranial aneurysms.For silent MRA and TOF MRA,the scores of signal homogeneity were 3.38±0.49 and 3.00±0.62,andthe scores of venous signal/artifact were 3.77±0.42 and 2.65±0.48.Significant differences were found between the two MRAs in these aspects(Z=-2.21,P=0.02;Z=-5.69,P=0.01).The scores of lesion conspicuity were 3.19±0.56 and 3.15±0.46,and the scores of diagnostic confidence were 3.27±0.44 and 3.12±0.51.There were no significant differences found in these aspects(P>0.05).The ICC coefficient was excellentfor silent MRA(0.94,95%CI 0.82-0.98)and was good for TOF MRA(0.72,95%CI 0.30-0.91)in tiny aneurysm group.The ICC coefficient was excellent(silent MRA,0.98,95%CI 0.95-0.99;TOF MRA,0.95,95%CI 0.87-0.98)for both MRA in non-tiny aneurysm group.Conclusions Compared with TOF MRA,silent MRA could achieve higher image quality and higher diagnostic confidence,and higher consistency with CTA.Silent MRA can be a promising
作者
尚松安
叶靖
罗先富
朱庆强
张洪英
吴晶涛
Shang Song'an;Ye Jing;Luo Xianfu;Zhu Qingqiang;Zhang Hongying;Wu Jingtao(Department of Medical Imaging,Clinical Medical College of Yangzhou University,Subei People's Hospital of Jiangsu Province,Yangzhou 225001,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2020年第4期325-331,共7页
Chinese Journal of Radiology
基金
国家自然科学基金(81571652)
江苏省"333工程"培养资金资助项目(BRA2017154)
扬州市社会发展项目(YZ2018059)。
关键词
磁共振成像
颅内动脉瘤
诊断
鉴别
对比研究
Magnetic resonance imaging
Intracranial aneurysm
Diagnosis
differential
Comparative study
