摘要:
目的:对照分析后循环缺血患者椎基底动脉的3D-TOP-MRA和DSA检查结果,探讨3D-TOP-MRA用于后循环缺血的诊断价值。方法:选取80例后循环缺血患者分别完成椎基底动脉的3D-TOP-MRA和DSA检查,以盲法判断动脉血管的狭窄情况,对比分析两种方法检测结果间的相关性,并系统评价3D-TOP-MRA的诊断效率。结果:以DSA为金标准,3D-TOP-MRA检测出狭窄血管的总体灵敏度为88.23%,轻度、中度、重度狭窄和闭塞的灵敏度分别为57.89%、96.30%、85.71%和100%。3D-TOP-MRA检查出狭窄血管总体特异度为66.67%,轻度、中度、重度狭窄和闭塞的特异度分别为100%、96.23%、92.42%和100%。3D-TOP-MRA检查出狭窄血管的总体准确度为85.00%,轻度、中度、重度狭窄和闭塞的准确度分别为90.00%、96.25%、91.25%和100%。结论:3D-TOP-MRA无创检测后循环缺血患者椎基底动脉的狭窄有较高的准确度和灵敏度,特别是中重度狭窄病例,可作为血管狭窄术前筛查、术后随访重要检查手段,有利于控制后循环缺血诊治过程中的临床风险。
Abstract:
Objective: To the diagnostic value of magnetic resonance angiography(3D-TOP-MRA) in detecting the posterior circulation ischemia(PCI), and utilize digital subtraction angiography(DSA) as the gold standard. Methods: 80 PCI patients' vertebral-basilar artery was examined both by DSA and 3D-TOP-MRA. And the sensitivity, specificity of 3D-TOP-MRA was compared with DSA. Results: 3D-TOP-MRA had a pooled sensitivity of 88.23% for artery stenosis, and the sensitivity of mild, moderate, severe stenosis and occlusion were 57.89%, 96.30%, 85.71% and 100%, respectively;3D-TOP-MRA had a pooled specificity of 66.67%, and the specificity of mild, moderate, severe stenosis and occlusion were 100%, 96.23%, 92.42% and 100%, respectively. The overall accuracy of 3D-TOP-MRA was 85.00%, and the accuracy of mild, moderate, severe stenosis and occlusion were 90.00%, 96.25%, 91.25% and 100%. Conclusion: 3D-TOP-MRA showed high accuracy and sensitivity for the detection of high-grade PCI stenosis and occlusions.