CAJ | 학술논문

目的：比较研究磁敏感加权成像与TOF-血管成像(MRA)两种方法对检查急性脑梗死中大脑中动脉主要血管段内急性血管闭塞的诊断准确性。材料与方法61例大脑中动脉供血区急性脑梗死患者均行常规磁共振(MRI)和DWl、SWI、TOF-MRA检查。对SWI检测到的磁敏感血管征象(SVS)与MRA检测的大脑中动脉主要血管段不同程度狭窄或闭塞频率通过McNemar检验进行比较。结果61例脑梗死病变在DW I图像上均显示高信号，47例患者的患侧大脑深髓静脉较对侧明显扩张。59例患者在SWI上明确清晰显示SVS，其中有56例患者的SVS与MRA显示的闭塞或狭窄位置相匹配。两种技术在检测M1段内血栓性闭塞的灵敏度没有明显差异(SWI：98.1%；MRA：98.1%)，而在检测M2/M3段血管内血栓的灵敏度存在显著差异(SWI：75.0%；MRA：37.5%；P<0.001)。结论 SWI和MRA均能检测到急性脑梗死中血管内血栓性闭塞或狭窄，其在检测主要血管狭窄或闭塞方面的灵敏性没有差别，但是在检测较小、迂曲动脉段及髓静脉方面SWI更具有优越性。
목적：비교연구자민감가권성상여TOF-혈관성상(MRA)량충방법대검사급성뇌경사중대뇌중동맥주요혈관단내급성혈관폐새적진단준학성。재료여방법61례대뇌중동맥공혈구급성뇌경사환자균행상규자공진(MRI)화DWl、SWI、TOF-MRA검사。대SWI검측도적자민감혈관정상(SVS)여MRA검측적대뇌중동맥주요혈관단불동정도협착혹폐새빈솔통과McNemar검험진행비교。결과61례뇌경사병변재DW I도상상균현시고신호，47례환자적환측대뇌심수정맥교대측명현확장。59례환자재SWI상명학청석현시SVS，기중유56례환자적SVS여MRA현시적폐새혹협착위치상필배。량충기술재검측M1단내혈전성폐새적령민도몰유명현차이(SWI：98.1%；MRA：98.1%)，이재검측M2/M3단혈관내혈전적령민도존재현저차이(SWI：75.0%；MRA：37.5%；P<0.001)。결론 SWI화MRA균능검측도급성뇌경사중혈관내혈전성폐새혹협착，기재검측주요혈관협착혹폐새방면적령민성몰유차별，단시재검측교소、우곡동맥단급수정맥방면SWI경구유우월성。
Objectives:The aim of this study was to compare the diagnostic accuracy of both methods of susceptibility weighted imaging (SWI) and time-of-flight MR angiography (TOF-MRA) in determining middle cerebral artery occlusion in patients with acute ischemic stroke. Materials and Methods:Sixty-one patients who presented with clinical symptoms for acute ischemic stroke in the territory of the middle (M1, M2/M3) cerebral artery (MCA) were performed with conventional MRI, DWI, SWI and TOF-MRA. The frequency of hypointense susceptibility vessel signs (SVS) on SWI and vessel occlusion or stenosis on TOF-MRA were compared using the McNemar test. Results:All of the 61 patients displayed hyperintention on DWI in the infarction area. Forty-seven patients showed larger deep medullary vein than the contralateral. Fifty-nine patients displayed a clearly deifnable SVS on SWI. In 56 patients the SVS was associated with occlusion or stenosis on TOF-MRA. Sensitivity for detection of thrombi within M1 did not show any signiifcant difference between both techniques (98.2%for both SWI and TOF-MRA) while the sensitivity for detection of thrombi within M2/M3 was significantly different (75.0% for SWI versus 37.5% for TOF-angiography, P<0.05). Conclusions:SWI and TOF-MRA provide similar sensitivity for acute embolic occlusion in stroke while SWI is superior for the detection of embolic occlusion in small, tortuous arterial vessel segments and deep medullary vein.