| 黄伟耀,肖叶玉,郑友康,王一焯,邹桂红,侯卫武,谢丽英,陈泽乐,周 雨,黄彩红.三维高分辨率磁共振血管壁成像对脑梗死患者血管狭窄的诊断价值分析[J].,2024,(7):1316-1320 |
| 三维高分辨率磁共振血管壁成像对脑梗死患者血管狭窄的诊断价值分析 |
| Analysis of the Diagnostic Value of Three-Dimensional High-Resolution Magnetic Resonance Vascular Wall Imaging for Vascular Stenosis in Patients with Cerebral Infarction |
| 投稿时间：2023-09-05 修订日期：2023-09-28 |
| DOI：10.13241/j.cnki.pmb.2024.07.022 |
| 中文关键词: 脑梗死 三维高分辨率磁共振血管壁成像 数字减影血管造影 血管狭窄 诊断 |
| 英文关键词: Cerebral infarction Three-dimensional high-resolution magnetic resonance vascular wall imaging Digital subtraction angiography Vascular stenosis Diagnosis |
| 基金项目:广州市花都区科技计划项目（22-HDWS-55）；广东省科技创新战略专项项目（2018A0303070002） |
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| 中文摘要: |
| 摘要 目的：探讨三维高分辨率磁共振血管壁成像（HR-MRI VWI）对脑梗死患者血管狭窄的诊断价值。方法：回顾性收集2022年1月至2022年10月于广州市中西医结合医院治疗的196例脑梗死患者的临床资料，所有患者均行HR-MRI VWI和数字减影血管造影（DSA）检查。记录脑梗死患者HR-MRI VWI成像特征，以DSA为金标准，Kappa检验HR-MRI VWI与DSA检出病变血管部位、血管狭窄程度的一致性。受试者工作特征（ROC）曲线分析HR-MRI VWI诊断脑梗死血管狭窄程度的价值。结果：HR-MRI VWI可检测到脑梗死病变血管区域皮层下梗死以及同侧病变血管内斑块，斑块HR-MRI VWI成像特征为斑块增强、阳性壁重塑、斑块T1高强度和斑块表面不规则，平均斑块负荷（75.09±12.13）%。DSA检出病变血管223支，HR-MRI VWI检出病变血管212支。HR-MRI VWI与DSA检出病变血管部位、血管狭窄程度一致性良好（Kappa值=0.802、0.775，P＜0.05）。HR-MRI VWI鉴别诊断脑梗死血管狭窄Ⅲ～Ⅳ级的曲线下面积为0.942，灵敏度为94.90%，特异度为93.60%，阳性预测值为92.08%，阴性预测值为95.90%。结论：HR-MRI VWI可准确判断脑梗死病变血管分布和血管狭窄程度，在脑梗死诊断中具有较高的价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the diagnostic value of three-dimensional high-resolution magnetic resonance vascular wall imaging (HR-MRI VWI) for vascular stenosis in patients with cerebral infarction. Methods: Retrospective collection of clinical data of 196 patients with cerebral infarction who were treated in Guangzhou Hospital of Integrated Chinese and Western Medicine from January 2022 to October 2022, all patients underwent HR-MRI VWI and digital subtraction angiography (DSA) examinations. The HR-MRI VWI imaging features of patients with cerebral infarction was recorded, used DSA as the gold standard. Consistency between HR-MRI VWI and DSA in detecting the location of diseased blood vessels and the degree of vascular stenosis was detected by kappa test. The value of HR-MRI VWI in diagnosing the degree of vascular stenosis in cerebral infarction was analyzed by receiver operating characteristic (ROC). Results: HR-MRI VWI could detected subcortical infarction and ipsilateral intravascular plaques in cerebral infarction lesion areas, the imaging features of plaques on HR-MRI VWI include plaque enhancement, positive wall remodeling, high intensity of plaque T1, and irregular plaque surface, with an average plaque load of (75.09±12.13)%. DSA detected 223 diseased vessels, and HR-MRI VWI detected 212 diseased vessels. The consistency between HR-MRI VWI and DSA in detecting the location of diseased vessels and the degree of vascular stenosis was good (Kappa values=0.802, 0.775, P<0.05). The area under the curve of HR-MRI VWI for differential diagnosis of cerebral infarction vascular stenosis grades III-IV was 0.942, the sensitivity was 94.90%, the specificity was 93.60%, the positive predictive value was 92.08%, and the negative predictive value was 95.90%. Conclusion: HR-MRI VWI can accurately determine the distribution and degree of vascular stenosis in cerebral infarction lesions, and has high value in the diagnosis of cerebral infarction. |
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