摘要
目的:探讨颅内时间飞跃法磁共振血管成像(3D TOF-MRA)技术在脑梗死患者出血性转化(HT)中的应用价值,从而为患者临床诊疗提供参考。方法:选取60例脑梗死HT患者为研究对象,所有患者均进行数字减影血管造影(DSA)、电子计算机断层扫描血管成像(CTA)以及3D TOF-MRA影像学检查。①比较CTA和3D TOF-MRA成像技术最终图像质量评分;②比较CTA和3D TOF-MRA对患者脑侧支循环情况的评估结果以及诊断效能;③比较CTA和3D TOF-MRA对患者血管狭窄程度的评估结果以及诊断效能。结果:①两名医师最终对CTA、3D TOF-MRA影像学图像质量评分中,3D TOF-MRA技术的血管可视化评分以及血管饱和伪影评分均显著优于CTA(均P<0.05);②以DSA为参考标准,对脑侧支循环的诊断中,3D TOF-MRA对一级侧支循环评估的准确度(88.33%)要高于CTA(85.00%),两种检测方法对二级侧支循环以及三级侧支循环评估的准确度无统计学差异,且CTA、3D TOF-MRA与DSA检查的一致性均良好(Kappa_(CTA)=0.613,Kappa_(3D TOF-MRA)=0.412,P=0.000);③以DSA为参考标准,对患者血管狭窄程度的诊断中,CTA、3D TOF-MRA诊断轻度狭窄、中度狭窄、重度狭窄以及闭塞的准确度均无统计学差异,且CTA、3D TOF-MRA与DSA检查的一致性均良好(Kappa_(CTA)=0.687,Kappa_(3D TOF-MRA)=0.588,P=0.000)。结论:采用3D TOF-MRA成像技术对脑梗死出血性转化患者进行检查,能够得到更加优质的图像,而且对患者部分脑侧支循环以及血管狭窄情况评估效果良好,可作为诊疗脑梗死HT患者的影像学检查方法。
Objective:To explore the application value of intracranial 3D TOF-MRA imaging technology in hemorrhagic transformation(HT)of patients with cerebral infarction,so as to provide reference for clinical diagnosis and treatment of patients.Methods:60 HT patients with cerebral infarction were selected as the research objects.All patients received DSA,CTA and 3D TOF-MRA imaging examinations.The final image quality scores of CTA and 3D TOF-MRA imaging technology were compared.The results and diagnostic efficacy of CTA and 3D TOF-MRA in assessing the degree of cerebral collateral circulation and vascular stenosis in patients were compared.Results:In the final scores of CTA and 3D TOF-MRA image quality by the two doctors,the blood vessel visualization score and blood vessel saturation artifact score of 3D TOF-MRA technology were significantly better than CTA(all P<0.05).Taking DSA as the reference standard,in the diagnosis of cerebral collateral circulation,the accuracy of 3D TOF-MRA in the assessment of first-level collateral circulation(88.33%)was higher than that of CTA(85.00%).There was no significant difference in the accuracy of the two detection methods for the assessment of secondary collateral circulation and tertiary collateral circulation,and both CTA and 3D TOF-MRA had good consistency with DSA inspection(Kappa_(CTA)=0.613,Kappa_(3D TOF-MRA)=0.412,P=0.000).Using DSA as reference standard,in the diagnosis of the degree of vascular stenosis in patients,there was no significant difference in the accuracy of CTA and 3D TOF-MRA in the diagnosis of mild stenosis,moderate stenosis,severe stenosis and occlusion,and both CTA and 3D TOF-MRA had good consistency with DSA inspection(Kappa_(CTA)=0.687,Kappa_(3D TOF-MRA)=0.588,P=0.000).Conclusion:Using 3D TOF-MRA imaging technology for examining hemorrhagic transformation patients with cerebral infarction can get better images.Moreover,it has good effect on the evaluation of part of the patients’cerebral collateral circulation and vascular stenosis.It can be used as an imaging examination method for the diagnosis and treatment of HT patients with cerebral infarction.
作者
王梦祥
黑欢欢
WANG Mengxiang;HEI Huanhuan(Department of Medical Imaging,the Second Affiliated Hospital of Xi’an Medical College,Xi’an 710038,China)
出处
《陕西医学杂志》
CAS
2022年第4期424-428,共5页
Shaanxi Medical Journal
基金
西安医学院第四批校级重点学科经费资助。
