3.0T MRI联合低浓度对比剂CE-MRA和灌注成像在急性缺血性脑卒中的应用价值

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摘要目的探讨在3.0T MRI联合低浓度对比剂增强磁共振血管成像（CE-MRA）和动态磁敏感灌注成像（DSC-PWI）在急性缺血性脑卒中的应用价值。方法收集南京市第一医院2017年10月～2018年3月急性脑卒中患者30例，所有患者均接受低浓度对比剂CE-MRA和DSC-PWI成像，并于24 h内接受数字减影血管造影（DSA）检查。CE-MRA和DSC-PWI均使用半剂量对比剂浓度（0.05 mmol/kg）。通过与DSA对照，评估CE-MRA对血管狭窄诊断的准确性。CE-MRA诊断血管狭窄及DSC-PWI诊断不匹配区的观察者间一致性检验使用Kappa分析。结果 CE-MRA对头颈动脉低级别（＜50%）及高级别（＞50%）狭窄诊断的敏感性、特异性、阳性预测值、阴性预测值分别为82.4%、100%、100%、93.8%及100%、82.4%、93.8%、100%。CE-MRA诊断动脉狭窄及DSC-PWI诊断不匹配区观察者之间一致性均好（κ = 0.87、0.86）。结论 3.0T MRI联合低浓度对比剂CE-MRA和DSC-PWI是一种可行的急性缺血性脑卒中MRI扫描方案。

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	姜海龙毛存南陈谦陈国中殷信道

关键词 ：急性缺血性脑卒中, 磁共振成像, 钆对比剂, 头颈动脉

Abstract：Objective To explore application value of low-dose contrast-enhanced MRA (CE-MRA) and dynamic susceptibility contrast perfusion imaging (DSC-PWI) at 3.0T in patients with acute ischemic stroke. Methods Thirty patients with acute ischemic stroke in Nanjing First Hospital from October 2017 to March 2018 were enrolled. All the patients underwent low-dose CE-MRA and DSC-PWI examination, and DSA examination was performed within 24 h. Half-dose contrast agent concentration (0.05 mmol/kg) was used in both CE-MRA and DSC-PWI. The accuracy of CE-MRA in the diagnosis of arterial stenosis was evaluated by comparing with DSA. Inter-observer agreement tests for diagnosis of arterial stenosis with CE-MRA and mismatched areas with DSC-PWI were tested by Kappa analysis. Results The sensitivity, specificity, positive predictive value and negative predictive value of CE-MRA in the diaognosis of low grade (＜50%) and high grade (＞50%) arterial stenosis of the intracranial and cervical arteries were 82.4%, 100%, 100%, 93.8%, 100% and 82.4%, 93.8%, 100%, respectively. The inter-observer agreements in the diagnosis of arterial stenosis with CE-MRA and mismatch area with DSC-PWI were both excellent (κ = 0.87, 0.86). Conclusion Low-dose CE-MRA and DSC-PWI combination at 3.0T MRI is a feasible MRI scanning protocal for patinets with acute ischemic stroke.

Key words： Acute ischemic stroke Magnetic resonance imaging Gadolinium contrast agents Intracranial and cervical arteries

引用本文:

姜海龙毛存南陈谦陈国中殷信道. 3.0T MRI联合低浓度对比剂CE-MRA和灌注成像在急性缺血性脑卒中的应用价值[J]. 中国医药导报, 2019, 16(10): 150-153.
JIANG Hailong MAO Cunnan CHEN Qian CHEN Guozhong YIN Xindao. Application value of low-dose contrast-enhanced MR angiography and perfusion imaging at 3.0T in patients with acute ischemic stroke. 中国医药导报, 2019, 16(10): 150-153.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I10/150

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