CAJ | 학술논문

目的：评估3.0T 非增强磁共振血管成像（NCE-MRA）诊断下肢动脉狭窄的价值，为临床提供可靠的检查方法。资料与方法30例拟诊为下肢动脉病变的患者行 NCE-MRA 检查后接受增强磁共振血管成像（CE-MRA）检查，评价两种检查方法的图像质量，并以 CE-MRA 为标准，评估 NCE-MRA 诊断动脉显著性狭窄（≥50%）的准确度，分析两者诊断动脉显著性狭窄（≥50%）的一致性。结果30例患者成功完成 NCE-MRA 和 CE-MRA 检查，NCE-MRA 具有诊断价值的动脉节段有532个。小腿段 NCE-MRA 图像静脉污染较 CE-MRA 少（Z=4.92，P<0.01），腹盆部、大腿段 NCE-MRA 图像静脉污染较 CE-MRA 多（Z=4.58、3.56，P<0.01）。NCE-MRA 诊断下肢动脉显著性狭窄（≥50%）的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为97.89%、97.69%、97.74%、93.92%、99.22%，两种检查方法诊断下肢动脉显著性狭窄（≥50%）的一致性较好（Kappa=0.94，P<0.05）。结论在显示下肢动脉狭窄方面，NCE-MRA 具有与 CE-MRA 相近的图像质量和诊断准确度，可以作为肾功能不全或不能使用对比剂的患者进行下肢动脉 MRA 检查的替代方法。
목적：평고3.0T 비증강자공진혈관성상（NCE-MRA）진단하지동맥협착적개치，위림상제공가고적검사방법。자료여방법30례의진위하지동맥병변적환자행 NCE-MRA 검사후접수증강자공진혈관성상（CE-MRA）검사，평개량충검사방법적도상질량，병이 CE-MRA 위표준，평고 NCE-MRA 진단동맥현저성협착（≥50%）적준학도，분석량자진단동맥현저성협착（≥50%）적일치성。결과30례환자성공완성 NCE-MRA 화 CE-MRA 검사，NCE-MRA 구유진단개치적동맥절단유532개。소퇴단 NCE-MRA 도상정맥오염교 CE-MRA 소（Z=4.92，P<0.01），복분부、대퇴단 NCE-MRA 도상정맥오염교 CE-MRA 다（Z=4.58、3.56，P<0.01）。NCE-MRA 진단하지동맥현저성협착（≥50%）적민감도、특이도、준학도、양성예측치、음성예측치분별위97.89%、97.69%、97.74%、93.92%、99.22%，량충검사방법진단하지동맥현저성협착（≥50%）적일치성교호（Kappa=0.94，P<0.05）。결론재현시하지동맥협착방면，NCE-MRA 구유여 CE-MRA 상근적도상질량화진단준학도，가이작위신공능불전혹불능사용대비제적환자진행하지동맥 MRA 검사적체대방법。
Purpose To evaluate the diagnostic significance of non-contrast enhanced magnetic resonance angiography (NCE-MRA) for lower extremity arterial stenosis on a 3.0T MR scanner, in order to provide a reliable method for clinical application. Materials and Methods Thirty patients with arterial disease in lower extremity underwent NCE-MRA before contrast enhanced magnetic resonance angiography (CE-MRA). Image quality of the two methods was compared. The diagnostic accuracy for significant stenosis ( ≥50%) of NCE-MRA was assessed using CE-MRA as a golden standard. The consistency of the two methods in diagnosis of significant stenosis ( ≥ 50%) was analyzed. Results All patients successfully underwent both NCE-MRA and CE-MRA examination. There were 532 arterial segments detected by NCE-MRA. In the calf region, venous artifacts presented more frequently on CE-MRA (Z=4.92, P<0.01), while in the abdominal and the femoral regions, venous artifacts presented more frequently on NCE-MRA (Z=4.58 and 3.56, P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NCE-MRA for the diagnosis of significant stenosis ( ≥ 50%) were 97.89%, 97.69%, 97.74%, 93.92% and 99.22%, respectively. There was good agreement (Kappa=0.94, P<0.05) between the two methods. Conclusion For the imaging of lower extremity arterial stenosis, NCE-MRA shows similar image quality and diagnostic accuracy with CE-MRA, thus can be used as an alternative method for lower extremity arterial stenosis in patients who have renal insufficiency or other contraindication of contrast media.