非对比增强MRA诊断轻中度肾功能不全合并肺栓塞

发布时间：2018-04-20 12:52

本文选题：磁共振血管成像 + CT血管成像　；参考：《放射学实践》2015年04期

【摘要】：目的:探讨空间标记多反转脉冲序列(SLEEK)非增强MR血管成像对轻中度肾功能不全合并肺栓塞(PE)的诊断准确性。方法:16例经CT肺动脉血管成像诊断为肺栓塞的轻中度肾功能不全患者,于CTPA检查48小时内行非增强SLEEK MRA检查。由2位放射诊断医师对图像进行分析,以CTPA作为参考标准,分别计算基于肺血管分区(8个分区)和每个栓子,非增强SLEEK MRA诊断肺栓子的敏感性、特异性、阳性预测值以及阴性预测值,并对2位医师诊断结果的一致性进行统计学分析。结果:按栓子的肺血管分区来统计,非增强SLEEK MRA诊断肺栓子的敏感度为84.5%,特异度100%,阳性预测值为100%,阴性预测值88.6%;基于每个栓子来进行分析,敏感度为78.0%,特异度99.7%,阳性预测值98.9%,阴性预测值92.7%。两位阅片者间诊断结果的一致性较好(Kappa=0.76)。结论:CTPA和(非增强)SLEEK MRA诊断肺栓塞的准确性无明显差异,但非增强SLEEK MRA无需使用对比剂,有利于肾功能不全怀疑肺栓塞患者的诊断。
[Abstract]:Objective: to evaluate the diagnostic accuracy of non-enhanced Mr angiography with multi-inversion pulse sequence (SLEEK) in the diagnosis of mild to moderate renal insufficiency with pulmonary embolism (PE). Methods Sixteen patients with mild and moderate renal insufficiency diagnosed as pulmonary embolism by CT pulmonary angiography were examined with non enhanced SLEEK MRA within 48 hours of CTPA. The images were analyzed by two radiologists. The sensitivity and specificity of non-enhanced SLEEK MRA in diagnosing pulmonary emboli were calculated based on the pulmonary vascular division (8 divisions) and each embolus, respectively, using CTPA as the reference standard. Positive predictive value and negative predictive value were analyzed statistically. Results: according to the pulmonary vascular division of embolus, the sensitivity of non-enhanced SLEEK MRA in diagnosing pulmonary embolus was 84.5, specificity was 100, positive predictive value was 100, negative predictive value was 88.6.The results were analyzed based on each embolus. The sensitivity was 78.0 and the specificity was 99.7. The positive predictive value was 98.9 and the negative predictive value was 92.7. The diagnostic results were consistent between the two radiographs. Conclusion there is no significant difference in the accuracy of MRA in the diagnosis of pulmonary embolism, but there is no need to use contrast agent for non-enhanced SLEEK MRA, which is beneficial to the diagnosis of renal insufficiency suspected pulmonary embolism.
【作者单位】：华中科技大学同济医学院附属同济医院放射科;
【分类号】：R445.2;R563.5

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