CAJ | 학술논문

目的：评价三维对比增强磁共振血管成像(3D CE-MRA)双期检查对头颈部动脉狭窄的诊断价值。方法收集行头颈3D CE-MRA 双期及数字减影血管造影技术(DSA)检查的脑血管病患者51例,将3D CE-MRA 动脉期、3D CE-MRA 双期、DSA 3种检查方法结果进行相关性比较。结果以 DSA 检查结果为标准,3D CE-MRA 动脉期诊断头颈动脉狭窄的敏感性为90.81%,特异性为92.96%,阳性预测值为71.79%,阴性预测值为98.09%,总符合率为92.60%,一致性率为91.35%,Kappa=0.730,ACU 值=0.922；CE-MRA 双期诊断头颈动脉狭窄的敏感性为90.81%,特异性为95.62%,阳性预测值为80.38%,阴性预测值为98.14%,总符合率为92.60%,一致性率为94.83%,Kappa=0.798,ACU 值=0.935；CE-MRA 动脉期与 DSA 检查对诊断头颈动脉狭窄诊断结果的配对卡方检验差异有统计学意义(P =0.000<0.05),3D CE-MRA 双期与 DSA 检查对诊断头颈动脉狭窄结果的差异无统计学意义(P =0.075>0.05)。结论3D CE-MRA 双期检查能进一步提高头颈部动脉狭窄诊断的准确性,减少 CE-MRA 动脉期检查对血管狭窄的过度诊断,是无创的头颈部动脉疾病筛查的有效方法,基本能够替代有创的 DSA 检查。
목적：평개삼유대비증강자공진혈관성상(3D CE-MRA)쌍기검사대두경부동맥협착적진단개치。방법수집행두경3D CE-MRA 쌍기급수자감영혈관조영기술(DSA)검사적뇌혈관병환자51례,장3D CE-MRA 동맥기、3D CE-MRA 쌍기、DSA 3충검사방법결과진행상관성비교。결과이 DSA 검사결과위표준,3D CE-MRA 동맥기진단두경동맥협착적민감성위90.81%,특이성위92.96%,양성예측치위71.79%,음성예측치위98.09%,총부합솔위92.60%,일치성솔위91.35%,Kappa=0.730,ACU 치=0.922；CE-MRA 쌍기진단두경동맥협착적민감성위90.81%,특이성위95.62%,양성예측치위80.38%,음성예측치위98.14%,총부합솔위92.60%,일치성솔위94.83%,Kappa=0.798,ACU 치=0.935；CE-MRA 동맥기여 DSA 검사대진단두경동맥협착진단결과적배대잡방검험차이유통계학의의(P =0.000<0.05),3D CE-MRA 쌍기여 DSA 검사대진단두경동맥협착결과적차이무통계학의의(P =0.075>0.05)。결론3D CE-MRA 쌍기검사능진일보제고두경부동맥협착진단적준학성,감소 CE-MRA 동맥기검사대혈관협착적과도진단,시무창적두경부동맥질병사사적유효방법,기본능구체대유창적 DSA 검사。
Objective To assess the diagnostic values of dual-phase 3D contrast enhanced MR angiography (3D CE-MRA)in craniocervical artery stenosis.Methods A total of 5 1 patients underwent dual-phase 3D CE-MRA and digital subtraction angiography (DSA).Then the correlative comparison of the diagnostic results of arterial-phase 3D CE-MRA,dual-phase 3D CE-MRA and DSA were performed.Results Compared with the results of DSA,the sensitivity,specificity,positive predictive values,negative predictive values,total corresponding rate,consistency rate,Kappa and ACU were 90.81%,92.96%,71.79%,98.09%,92.60%,91.35%,0.730 and 0.922,respectively in arterial-phase 3D CE-MRA.and 90.81%,95.62%,80.38%,98.14%,92.60%,94.83%,0.798 and 0.935,respectively in dual-phase 3D CE-MRA.The Chi-sqaure test showed that,there was a statistically significant difference between arterial-phase 3D CE-MRA and DSA (P =0.000<0.05),but no statistically significant difference between dual-phase 3D CE-MRA and DSA (P =0.075 >0.05 ). Conclusion The dual-phase 3D CE-MRA can improve the accuracy of diagnosing craniocervical artery stenosis,and reduce over-diag-nosis based on arterial-phase 3D CE-MRA examination.It is a non-invasive and effective method of craniocervical artery stenosis screening,which may take the place of the invasive DSA examination.