放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2015年
4期
332-337
,共6页
磁共振血管成像%CT血管成像%肺动脉%肺动脉栓塞%肾功能不全%诊断
磁共振血管成像%CT血管成像%肺動脈%肺動脈栓塞%腎功能不全%診斷
자공진혈관성상%CT혈관성상%폐동맥%폐동맥전새%신공능불전%진단
Magnetic resonance angiography%Computed tomography angiography%Pulmonary artery emblism%Re-nal dysfunction%Diagnosis
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。
目的：探討空間標記多反轉脈遲序列（SLEEK）非增彊 MR 血管成像對輕中度腎功能不全閤併肺栓塞（PE）的診斷準確性。方法：16例經CT肺動脈血管成像診斷為肺栓塞的輕中度腎功能不全患者，于CTPA檢查48小時內行非增彊SLEEK MRA檢查。由2位放射診斷醫師對圖像進行分析，以CTPA作為參攷標準，分彆計算基于肺血管分區（8箇分區）和每箇栓子，非增彊SLEEK MRA診斷肺栓子的敏感性、特異性、暘性預測值以及陰性預測值，併對2位醫師診斷結果的一緻性進行統計學分析。結果：按栓子的肺血管分區來統計，非增彊SLEEK MRA 診斷肺栓子的敏感度為84．5％，特異度100％，暘性預測值為100％，陰性預測值88．6％；基于每箇栓子來進行分析，敏感度為78．0％，特異度99．7％，暘性預測值98．9％，陰性預測值92．7％。兩位閱片者間診斷結果的一緻性較好（Kappa＝0．76）。結論：CTPA 和（非增彊） SLEEK MRA診斷肺栓塞的準確性無明顯差異，但非增彊SLEEK MRA無需使用對比劑，有利于腎功能不全懷疑肺栓塞患者的診斷。
목적：탐토공간표기다반전맥충서렬（SLEEK）비증강 MR 혈관성상대경중도신공능불전합병폐전새（PE）적진단준학성。방법：16례경CT폐동맥혈관성상진단위폐전새적경중도신공능불전환자，우CTPA검사48소시내행비증강SLEEK MRA검사。유2위방사진단의사대도상진행분석，이CTPA작위삼고표준，분별계산기우폐혈관분구（8개분구）화매개전자，비증강SLEEK MRA진단폐전자적민감성、특이성、양성예측치이급음성예측치，병대2위의사진단결과적일치성진행통계학분석。결과：안전자적폐혈관분구래통계，비증강SLEEK MRA 진단폐전자적민감도위84．5％，특이도100％，양성예측치위100％，음성예측치88．6％；기우매개전자래진행분석，민감도위78．0％，특이도99．7％，양성예측치98．9％，음성예측치92．7％。량위열편자간진단결과적일치성교호（Kappa＝0．76）。결론：CTPA 화（비증강） SLEEK MRA진단폐전새적준학성무명현차이，단비증강SLEEK MRA무수사용대비제，유리우신공능불전부의폐전새환자적진단。
Objective:To evaluate the accuracy of unenhanced MR angiography using spatial labeling with multiple in-version pulses sequence (SLEEK)in diagnosis of pulmonary embolism (PE)in patients with mild or moderate renal dys-function.Methods:16 patients with mild or moderate renal dysfunction were diagnosed as PE by CT pulmonary angiography (CTPA),and then all patients underwent SLEEK MRA within 48 hours after CTPA.All the MRA data were analyzed by two radiologists independently.Using CTPA as the gold standard,the sensitivity,specificity,positive and negative predictive values of SLEEK MRA in diagnosis of pulmonary emboli on pulmonary artery segment basis (if a pulmonary artery segment had one or more than one emboli,the pulmonary artery segment was defined as with pulmonary emboli)and on per-embolus basis were calculated,and the diagnostic results of the two radiologists were compared using Kappa test.Results:On basis of pulmonary artery segment,the sensitivity,specificity,positive predictive value (PPV)and negative predictive value (NPV) of SLEEK MRA in diagnosis of PE were 84.5%,100%,100% and 88.6%,respectively;On basis of the number of embo-lus,the sensitivity,specificity,PPV and NPV were 78.0%,99.7%,98.9% and 92.7%,respectively.Agreement between the two radiologists was relatively high (Kappa= 0.76).Conclusion:CTPA and SLEEK MRA have relatively similar sensi-tivity and specificity in diagnosis of PE;but the non-invasive property and no need of contrast agent of SLEEK MRA will be beneficial to suspected PE patients with renal dysfunction.
