中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2012年
5期
435-440
,共6页
吴倩%李明华%张佳胤%李永东
吳倩%李明華%張佳胤%李永東
오천%리명화%장가윤%리영동
磁共振成像%血管造影术,数字减影%对比研究
磁共振成像%血管造影術,數字減影%對比研究
자공진성상%혈관조영술,수자감영%대비연구
Magnetic resonance imaging%Angiography,digital subtraction%Comparative study
目的 比较4D动态MRA(4D-TRAK)与3D时间飞跃法MRA (3D-TOF-MRA)诊断脑动脉瘤的准确度与可靠性.方法 52例疑似脑动脉瘤患者顺序接受3D-TOF-MRA、4D-TRAK及3D-DSA检查.4D-TRAK结合敏感编码(SENSE)及对比增强时间稳定血管成像(CENTRA)k空间技术,采用单剂量注射10ml对比剂在3.0TMR仪上进行扫描.以3D-DSA为金标准,分别以每例患者及每枚动脉瘤为单位,比较分析4D-TRAK与3D-TOF-MRA诊断脑动脉瘤的准确度与可靠性.通过配对Wilcoxon符号秩和检验对2组图像的质量及诊断准确度进行统计分析.结果 3D-DSA共确诊58枚动脉瘤,4D-TRAK发现51枚,其中假阳性2枚,假阴性9枚；3D-TOF-MRA发现58枚,其中假阳性1枚,假阴性1枚.4D-TRAK与3D-TOF-M RA诊断脑动脉瘤的准确度、敏感度及特异度(以患者为单位)分别为92.31％( 48/52)、93.33％( 42/45)、85.71％ (6/7)和98.08％ (51/52)、100.00％( 45/45)、85.71％(6/7).诊断多发动脉瘤的准确度、敏感度及特异度(以动脉瘤为单位)分别为74.07％(20/27)、75.00％ (18/24)、66.67％ (2/3)和96.30％( 26/27)、95.83％( 23/24)、100.00％(3/3).亚组分析显示,19枚最大径＜3 mm的动脉瘤中,4D-TRAK漏诊了9枚,3D-TOF-MRA漏诊了1枚,差异有统计学意义(Z=-2.464,P＜0.01).其余39枚最大径≥3 mm的动脉瘤在4D-TRAK与3D-TOF-MRA上均得到显示,差异无统计学意义(Z=0.000,P＞0.05).对于4枚最大径≥10 mm的脑动脉瘤,4D-TRAK较3D-TOF-MRA能更完整地显示动脉瘤的大小及形态.结论 将4D-TRAK技术与SENSE、CENTRA k空间技术以及3.0T MR结合显示了其在诊断脑动脉瘤上的潜在价值,但其诊断的准确度仍低于3D-TOF-MRA.在大或巨大动脉瘤需完整显示瘤体形态或需应用低剂量对比剂时,4D-TRAK可作为一种简便的评估手段.
目的 比較4D動態MRA(4D-TRAK)與3D時間飛躍法MRA (3D-TOF-MRA)診斷腦動脈瘤的準確度與可靠性.方法 52例疑似腦動脈瘤患者順序接受3D-TOF-MRA、4D-TRAK及3D-DSA檢查.4D-TRAK結閤敏感編碼(SENSE)及對比增彊時間穩定血管成像(CENTRA)k空間技術,採用單劑量註射10ml對比劑在3.0TMR儀上進行掃描.以3D-DSA為金標準,分彆以每例患者及每枚動脈瘤為單位,比較分析4D-TRAK與3D-TOF-MRA診斷腦動脈瘤的準確度與可靠性.通過配對Wilcoxon符號秩和檢驗對2組圖像的質量及診斷準確度進行統計分析.結果 3D-DSA共確診58枚動脈瘤,4D-TRAK髮現51枚,其中假暘性2枚,假陰性9枚；3D-TOF-MRA髮現58枚,其中假暘性1枚,假陰性1枚.4D-TRAK與3D-TOF-M RA診斷腦動脈瘤的準確度、敏感度及特異度(以患者為單位)分彆為92.31％( 48/52)、93.33％( 42/45)、85.71％ (6/7)和98.08％ (51/52)、100.00％( 45/45)、85.71％(6/7).診斷多髮動脈瘤的準確度、敏感度及特異度(以動脈瘤為單位)分彆為74.07％(20/27)、75.00％ (18/24)、66.67％ (2/3)和96.30％( 26/27)、95.83％( 23/24)、100.00％(3/3).亞組分析顯示,19枚最大徑＜3 mm的動脈瘤中,4D-TRAK漏診瞭9枚,3D-TOF-MRA漏診瞭1枚,差異有統計學意義(Z=-2.464,P＜0.01).其餘39枚最大徑≥3 mm的動脈瘤在4D-TRAK與3D-TOF-MRA上均得到顯示,差異無統計學意義(Z=0.000,P＞0.05).對于4枚最大徑≥10 mm的腦動脈瘤,4D-TRAK較3D-TOF-MRA能更完整地顯示動脈瘤的大小及形態.結論 將4D-TRAK技術與SENSE、CENTRA k空間技術以及3.0T MR結閤顯示瞭其在診斷腦動脈瘤上的潛在價值,但其診斷的準確度仍低于3D-TOF-MRA.在大或巨大動脈瘤需完整顯示瘤體形態或需應用低劑量對比劑時,4D-TRAK可作為一種簡便的評估手段.
목적 비교4D동태MRA(4D-TRAK)여3D시간비약법MRA (3D-TOF-MRA)진단뇌동맥류적준학도여가고성.방법 52례의사뇌동맥류환자순서접수3D-TOF-MRA、4D-TRAK급3D-DSA검사.4D-TRAK결합민감편마(SENSE)급대비증강시간은정혈관성상(CENTRA)k공간기술,채용단제량주사10ml대비제재3.0TMR의상진행소묘.이3D-DSA위금표준,분별이매례환자급매매동맥류위단위,비교분석4D-TRAK여3D-TOF-MRA진단뇌동맥류적준학도여가고성.통과배대Wilcoxon부호질화검험대2조도상적질량급진단준학도진행통계분석.결과 3D-DSA공학진58매동맥류,4D-TRAK발현51매,기중가양성2매,가음성9매；3D-TOF-MRA발현58매,기중가양성1매,가음성1매.4D-TRAK여3D-TOF-M RA진단뇌동맥류적준학도、민감도급특이도(이환자위단위)분별위92.31％( 48/52)、93.33％( 42/45)、85.71％ (6/7)화98.08％ (51/52)、100.00％( 45/45)、85.71％(6/7).진단다발동맥류적준학도、민감도급특이도(이동맥류위단위)분별위74.07％(20/27)、75.00％ (18/24)、66.67％ (2/3)화96.30％( 26/27)、95.83％( 23/24)、100.00％(3/3).아조분석현시,19매최대경＜3 mm적동맥류중,4D-TRAK루진료9매,3D-TOF-MRA루진료1매,차이유통계학의의(Z=-2.464,P＜0.01).기여39매최대경≥3 mm적동맥류재4D-TRAK여3D-TOF-MRA상균득도현시,차이무통계학의의(Z=0.000,P＞0.05).대우4매최대경≥10 mm적뇌동맥류,4D-TRAK교3D-TOF-MRA능경완정지현시동맥류적대소급형태.결론 장4D-TRAK기술여SENSE、CENTRA k공간기술이급3.0T MR결합현시료기재진단뇌동맥류상적잠재개치,단기진단적준학도잉저우3D-TOF-MRA.재대혹거대동맥류수완정현시류체형태혹수응용저제량대비제시,4D-TRAK가작위일충간편적평고수단.
Objective To evaluate the accuracy and reliability of 4D time-resolved MRA with keyhole (4D-TRAK) for the detection and characterization of cerebral aneurysms ( CAs),with a comparison of 3D time-of-flight MRA (3D-TOF-MRA).Methods 3D-TOF-MRA,4D-TRAK and 3D-DSA were performed sequentially in 52 patients with suspected CAs.4D-TRAK was acquired using a combination of sensitivity encoding (SENSE) and contrast-enhanced (CE) timing robust angiography ( CENTRA ) k-space sampling techniques at a contrast dose of 10 ml at 3 T scanner. Accuracy,sensitivity,specificity of 4D-TRAK and 3D-TOF-MRA were calculated and compared for the detection of CAs on patient-based and aneurysm-based evaluation using 3D-DSA as a reference. Wilcoxon signed rank test were used. Results The overall image quality of 4D-TRAK was appropriate for the diagnostic purpose,but yet not comparable with that of 3D-TOF-MRA.In 52 patients with suspected GAs,58 CAs were confirmed on 3D-DSA finally.Fifty-one (with 2 false-positives and 9 false-negatives) and 58 (with 1 false-positive and 1 false-negative)CAs were visualized on 4D-TRAK and 3D-TOF-MRA,respectively.Accuracy,sensitivity and specificity on patient-based evaluation of 4D-TRAK and 3D-TOF-MRA were 92.31％ ( 48/52 ),93.33％ ( 42/45 ),85.71 ％ (6/7) and 98.08％ ( 51/52 ),100.00％ ( 45/45 ),85.71％ ( 6/7 ),respectively,and 74.07％(20/27),75.00％ ( 18/24),66.67％ (2/3) and 96.30％ (26/27),95.83％ (26/27),100.00％ (3/3)on aneurysm-based evaluation in patients with multiple CAs,respectively.Subgroup analysis revealed that for 19 very small CAs ( maximal diameter ＜3 mm,measured on 3D-DSA),9 were missed on 4D-TRAK and 1 on 3D-TOF-MRA( Z =- 2.464,P ＜ O.01 ). However,for 39 CAs with maximal diameter more than 3 mm,there was no significantly difference in the diagnostic accuracy (39 on 4D-TRAK vs.39 on 3D-TOFMRA) (Z =0.000,P ＞0.05).In 4 large CAs with maximal diameter more than 10 mm,4D-TRAK provided a better characterization of morphology than 3D-TOF-MRA.Conclusions 4D-TRAK with a combination of SENSE and CENTRA at 3 T shows potential value in the diagnosis of cerebral aneurysms.However,due to the compromise in spatial resolution and "vascular edge" artifacts,it does not yet have a diagnostic accuracy of CAs comparable with 3D-TOF-MRA.TRAK imaging can be of great help in patients with large-giant CAs to characterize the morphology of CAs and to diminish the risk of NSF in patients with renal impairment by using a lower-dose contrast.
