The diagnostic value of three-dimensional contrast-enhanced MR angiography in the arterial disease of the neck region
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 1
- DOI:
- 10.3760/j.issn:1005-1201.2004.01.016
- Key Word:
- 颈动脉疾病;椎动脉;磁共振血管造影术;造影剂
Abstract： 目的分析三维对比剂增强MR血管成像(3D CE-MRA)显示的颈部动脉常见病变;与DSA比较,明确3D CE-MRA诊断颈部动脉病变的价值.方法对741例超声多普勒怀疑颈部动脉疾病的患者进行3D CE-MRA成像,并根据其病变表现总结分类.206例病人同时行DSA检查,将颈部动脉分为颈总、颈内、颈外、锁骨下及椎动脉5个部位,由2位放射学专家独立评估DSA及3D CE-MRA血管资料.结果 36.7%病例(272/741)显示无异常.63.29%(469/741)显示颈部动脉有病变,共计827段,其中动脉粥样斑块占34.22%(283段),动脉狭窄占34.46%(285段),动脉闭塞占3.38%(28段),动脉发育纤细占14.87%(123段);动脉开口变异占3.87%(32段),动脉扭曲占3.63%(30段),动脉瘤占0.72%(6段),动脉夹层占1.21%(10段),肿瘤包绕或推压动脉占1.45%(12段),术后复查占2.18%(18段).对206例的412段血管与DSA比较, 3D CE-MRA在颈总动脉、颈内动脉及椎动脉的阳性检出率差异有显著性意义(P<0.01),主要是对动脉粥样斑块(256段与283段)和动脉狭窄(258段与 285段)存在一定的高估.但对412段血管整个样本,两种方法在同一部位诊断各种血管病变差异无显著性意义(P>0.05).以DSA为标准,3D CE-MRA诊断颈部5个部位血管病变的准确度分别为:锁骨下动脉99.51%,颈外动脉98.54%,颈总动脉96.60%,颈内动脉96.36%,椎动脉93.93%;诊断各部位动脉斑块、血管狭窄、血管闭塞的准确度分别为97.71%、97.62%及100.0%.结论 3D CE-MRA是有效可靠的颈部动脉病变诊断方法,能基本替代DSA.
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