Time-SLIP、CE-MRA、DSA在颈动脉斑块管腔狭窄检查的对照研究

发布时间：2018-05-18 09:35

本文选题：颈动脉 + 磁共振成像　；参考：《中国医学计算机成像杂志》2017年04期

【摘要】：目的:评估Time-SLIP血管成像的成像质量,评价Time-SLIP、CE-MRA以及DSA在颈动脉狭窄度评估方面的差异。方法:(1)35例具有颈动脉斑块的患者先后使用磁共振进行Time-SLIP和CE-MRA扫描,其中10例患者三天后进一步行颈动脉DSA检查。(2)在获取Time-SLIP和CE-MRA颈动脉血管图像后分别由两位副高级影像诊断医师对每幅图像质量、组织污染情况进行技术评分。(3)对Time-SLIP、CEMRA显示的血管数量进行评价。(4)对其中进行过DSA检查的10例患者,以NASCET法计算上述三种方法显示的颈动脉血管狭窄率。结果:(1)35例患者,Time-SLIP组和CE-MRA组中,图像质量为3分以上者分别占94.2%、97.1%;组织污染评分小于等于1分者分别占88.6%、82.9%;双侧颈动脉总共210条血管,Time-SLIP和CE-MRA分别显示两侧颈总动脉、颈内动脉及颈外动脉血管为199/210条和202/210条,其符合率分别为94.8%和96.2%。上述诊断两位医师的一致性较高,Kappa值0.80,两种方法的差异无统计学意义(P0.05)。(2)其中接受DSA检查的10例患者,以DSA诊断为金标准,在颈动脉狭窄的诊断中Time-SLIP诊断的敏感性92.31%,特异性97.87%,准确性96.67%,Kappa=0.90;CE-MRA诊断的敏感性100%,特异性97.87%,准确率98.33%,Kappa=0.95。结论:(1)Time-SLIP是一种无创MRA成像技术,成像质量较好。(2)Time-SLIP可以用于颈动脉狭窄评估。(3)由于Time-SLIP技术能有效提示管腔狭窄程度,因此其有较高的临床应用价值。
[Abstract]:Objective: to evaluate the imaging quality of Time-SLIP angiography and evaluate the difference between Time-SLIPP CE-MRA and DSA in evaluating carotid artery stenosis. Methods Time-SLIP and CE-MRA scans were performed in 35 patients with carotid plaques. After 3 days, 10 patients underwent further carotid DSA examination. (2) after obtaining Time-SLIP and CE-MRA carotid artery images, the quality of each image was evaluated by two deputy senior imaging diagnostics, respectively. Tissue contamination was evaluated by the technique score. The number of vessels displayed by Time-SLIPP CEMRA was evaluated. Among them, 10 patients who had been examined by DSA were evaluated by NASCET method. The carotid artery stenosis rate was calculated by NASCET method. Results in the time-slip group (n = 35) and CE-MRA group (n = 35), there were 94.2% and 97.1% of the patients whose image quality was above 3; 82.9% of the patients with a tissue pollution score less than or equal to 1; the bilateral carotid artery showed bilateral common carotid arteries with a total of 210 Time-SLIP and CE-MRA, respectively. The internal carotid artery and external carotid artery were 199 / 210 and 22 / 210 respectively, and the coincidence rates were 94. 8% and 96. 2%, respectively. There was a high consistency between the two physicians in the above diagnosis, and the Kappa value was 0.80. There was no significant difference between the two methods (P 0.05). Among the 10 patients who received DSA examination, the diagnostic value of DSA was taken as the gold standard. In the diagnosis of carotid artery stenosis, the sensitivity of Time-SLIP is 92.31, the specificity is 97.87, the accuracy is 96.677.0.90 CE-MRA, the sensitivity is 100, the specificity is 97.87 and the accuracy is 98.33. Conclusion\%\
【作者单位】：宁夏医科大学;上海市浦东新区公利医院影像科;
【基金】：上海市浦东新区科技发展基金(PKJ2014-Y20) 上海市卫生和计划生育委员会基金(No:201440458) 上海市浦东新区公利医院青年基金(2015YQNJJ-11)~~
【分类号】：R445.2;R543.4

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