磁共振 3D-ASL 技术对短暂性脑缺血发作的诊断价值

谢录玲 ^① ,史 纲,王润强,高井海,谢 春

(青海省第五人民医院,青海 西宁 810007)

摘要　目的:探究磁共振三维动脉自旋标记(3D-ASL)技术对短暂性脑缺血发作(TIA)的临床诊断价值。 方法:选取 98 例 TIA 患者作为研究对象,TIA 患者均采用 3D-ASL 和磁共振血管成像(MRA)检查。 MRA 检查采用三维时间飞跃法(3D-TOF),并以数字减影血管造影术(DSA)诊断结果作为金标准,分析3D-TOF MRA、3D-ASL 诊断敏感度、特异度和准确度,以及与 DSA 诊断结果的一致性。 结果:3D-TOF MRA 诊断 TIA 结果与 DSA 诊断结果的一致性较为理想(Kappa = 0.458,P<0.05);3D-ASL诊断 TIA 结果与 DSA 诊断结果的一致性较为理想(Kappa = 0.692,P<0.05);3D-ASL 诊断TIA 的敏感度、准确度高于 3D-TOF MRA(P<0.05)。 结论:磁共振3D-ASL技术诊断 TIA 敏感度及准确度较高,有利于早期发现 TIA 患者,并及时进行诊治,以改善患者预后。

关键词: 短暂性脑缺血发作;磁共振三维动脉自旋标记技术;磁共振血管成像;诊断效能

中图分类号:R743.31　　　　文献标志码:A　　　　文章编号:1008-2409(2022)03-0032-04

Diagnostic value of magnetic resonance 3D-ASL technique in patients with transient ischemic attack XIE Luling ① , SHI Gang, WANG Runqiang, GAO Jinghai, XIE Chun.(The 5 th People’s Hospital of Qinghai, Xining 810007, China)

Abstract　 Objective: To investigate the clinical value of 3D arterial spin labeling (3D-ASL) in the diagnosis of patients with transient ischemic attack(TIA). Methods: A total of 98 patients with TIA were selected as the study subjects. All patients with TIA were examined by 3D-ASL and magnetic resonance angiography(MRA). MRA was examined by 3D time of flight(3D-TOF), and the diagnostic results of digital subtraction angiography(DSA)were used as the gold standard to analyze the diagnostic sensitivity, specificity and accuracy of 3D-TOF MRA and 3D-ASL, and the consistency with DSA diagnosis as well.

Results: The consistency of diagnostic results of TIA by 3D-TOF MAR and DSA was satisfactory(Kappa=0.458, P<0.05); the consistency of diagnostic results of TIA by 3D-ASL and DSA was satisfactory(Kappa=0.692, P<0.05); the diagnostic sensitivity and accuracy of TIA by 3D-ASL was higher than by 3D-TOF MAR(P<0.05). Conclusion: MR 3D-ASL has high sensitivity and accuracy in the diagnosis of patients with TIA, which is conducive to early detection of TIA patients and timely diagnosis and treatment, so as to improve the prognosis of patients.

Keywords: transient ischemic attack(TIA); magnetic resonance 3D arterial spin labeling(MR 3D-ASL);magnetic resonance angiography(MRA); diagnostic efficiency

参考文献:

[1] 张勇,谭守文,严兴亚,等.短暂性脑缺血发作对前循环脑梗死临床预后的影响及作用机制探讨[J].中西医结合心脑血管病杂志,2021,19(9):1587-1589.

[2] 吴彩葵,韦礼华,方芳.NIHSS、ABCD2 联合头颅磁共振评估短暂性脑缺血发作发生脑梗死的风险[J].中国医学创新,2018,15(11):1-5.

[3] 王化强,刘颖娜.TCD、MRA 及与 DSA 在诊断缺血性脑血管病颅内动脉狭窄的对比研究[J].中国 CT 和 MRI 杂志,2019,17(1):47-49,129.

[4] 白秋云,甘洁.磁共振多模态影像技术在短暂性脑缺血发作中的临床应用价值[J].医学影像学杂志,2020,30(4):547-551.

[5] 尉胜男,王珂,郑建民,等.MR 3D-ASL 联合 MRA 诊断TIA 的价值分析[J].中国 CT 和 MRI 杂志,2021,19(2):26-28.

[6] LU F,YANG J,YANG S H,et al.Use of three-dimensional arterial spin labeling to evaluate renal perfusion in patients with chronic kidney disease[J]. J Magn Reson Imaging,2021,54(4):1152-1163.

[7] 王青川,马国诏,王爱华.短暂性脑缺血发作短期内脑梗死发生风险的预测[J].中华保健医学杂志,2019,21(1):13-16.

[8] 王丽萍,刘秀萍,张志刚,等.后循环短暂性脑缺血发作与后循环急性脑梗死患者颈动脉内-中膜厚度、收缩期血流峰值和椎动脉内径差异研究[J].中国医学创新,2020,17(1):154-157.

[9] 牛勤凤,徐红维.脑血流灌注 SPECT/ CT 显像与脑 MRI 联合应用对缺血性脑血管疾病的诊断价值[J].贵州医药,2020,44(9):1455-1456.

[10] 宋宇,晁迎九,徐运军.磁共振 3D TOF-MRA 和 ZTE-MRA 在脑血管成像的对比[J].中国医学物理学杂志,2020,37(12):1529-1533.

[11] 高丹.缺血性脑血管病 DWI 及 MRA 影像学表现及诊断价值[J].中国实验诊断学,2020,24(10):1644-1646.

[12] 程春红,李鸿波,黄炯.MRA、3D-ASL 脑灌注成像技术诊断缺血性脑血管疾病的一致性比较[J].中国实验诊断学,2020,24(5):809-811.

[13] 于秀英,何勇,赵小燕,等.3D-ASL 联合 MRA 在短暂性脑缺血发作中的应用价值研究[J].中国医疗设备,2020,35(3):77-79.

[14] ROBERTS D A,DETRE J A,BOLINGER L,et al.Quantitative magnetic resonance imaging of human brain perfusion at 1.5 T using steady-state inversion of arterial water[J].Proc Natl Acad Sci U S A,1994,91(1):33-37.

[15] 钱晶晶,吴卿杰,陆忠烈,等.MRI 三维动脉自旋标记法对 TIA 的诊断价值[J]. 临床神经病学杂志,2020,33(2):98-101.

[16] 王树春,马智军,孙世杭.3D-ASL 在 TIA 预后的前瞻性评价中的价值[J].医学影像学杂志,2019,29(11):1837-1839.

[17] BOHARA M,NAKAJO M,KAMIMURA K,et al.Visualization of incidentally imaged pituitary gland on three-dimensional arterial spin labeling of the brain[J].Br J Radiol,2021,94(1122):1-6.

[18] 胡明辉.MR 三维动脉自旋标记技术联合磁共振血管成像诊断短暂性脑缺血发作的价值[J].临床与病理杂志,2019,39(9):1977-1982.

[19] 李璇,吴江,杨朝慧,等.MRA、3D-ASL 及 IVIM 技术在短暂性脑缺血发作中的应用价值研究[J].磁共振成像,2020,11(5):321-325.

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