3D-VISTA在自发性头颈动脉夹层中的诊断价值

发布时间：2018-05-21 07:13

本文选题：自发性头颈动脉夹层 + 壁间血肿　；参考：《临床放射学杂志》2017年04期

【摘要】：目的分析自发性头颈动脉夹层(SCAD)在三维容积各向同性快速自旋回波(3D-VISTA)高分辨率磁共振成像(HRMRI)中的影像学特征,并探讨3D-VISTA HRMRI在SCAD的应用价值。方法搜集头颈部血管同时行DSA及3D-VISTA扫描的51例患者(65支血管),以DSA为诊断金标准,计算3D-VISTA诊断SCAD的敏感性、特异性等指标。结果 DSA及3D-VISTA分别诊断夹层17例(19支血管)和19例(24支)。3D-VISTA诊断夹层敏感性为84.2%,特异性为82.6%,阳性预测值为66.7%,阴性预测值为92.7%。壁间血肿(14支)、内膜片(13支)、双腔征(8支)、动脉瘤样扩张(6支)、壁间血肿或假腔沿真腔呈螺旋状走行(9支)为SCAD在3D-VISTA中的特征性影像征象。结论 3D-VISTA能同时显示管腔及管壁信息,对壁间血肿敏感性高,对于其他影像学检查无法确诊的夹层病例,可行病变段血管3D-VISTA扫描,提高诊断正确率。
[Abstract]:Objective to analyze the imaging features of spontaneous dissection of head and neck artery (SCAD) in 3D volumetric isotropic fast spin echo (3D-VISTA-HRMRI), and to discuss the value of 3D-VISTA HRMRI in SCAD. Methods 65 branches of DSA and 3D-VISTA were collected from 51 patients with head and neck blood vessels. The sensitivity and specificity of 3D-VISTA in the diagnosis of SCAD were calculated by using DSA as the diagnostic gold standard. Results the sensitivity, specificity, positive predictive value and negative predictive value of DSA and 3D-VISTA in diagnosis of dissection were 84.2, 82.6, 66.7 and 92.7g, respectively. The imaging features of SCAD in 3D-VISTA were as follows: 14 intramural hematoma, 13 endomembrances, 8 double lumen signs, 6 aneurysm dilatation, and 9 intra wall hematoma or pseudo-cavity spiraling along true cavity. Conclusion 3D-VISTA can display the information of lumen and wall at the same time, and has high sensitivity to intermural hematoma. For other dissection cases which can not be diagnosed by imaging examination, 3D-VISTA scan of diseased segment can be used to improve the diagnostic accuracy.
【作者单位】：南方医科大学珠江医院放射科;
【基金】：广东省科技计划资助项目(编号:2014A020212726)
【分类号】：R743

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