目的:探讨3.0T 3D TOF MRA对颅内血管狭窄术前评估的可靠性.方法:哈尔滨医科大学附属二院30例颅内动脉狭窄患者,均行3.0T 3D TOF MRA和旋转数字减影血管成像(DSA)检查.分析30例患者的450个血管片段.以DSA为诊断标准,以有无狭窄、轻度狭窄(10％～＜50％)、狭窄50％、70％、100％为判定点计算敏感性、特异性、阳性预测值(PPV)及阴性预测值(NPV).结果:共发现115段病变血管,MRA发现狭窄的敏感性、特异性分别为87.0％和99.7％;以50％为界点分别是86.7％和99.5％,PPV 92.9％和NPV 99.1％;以70％为界点分别是95.5％、99.5％、PPV 91.3％和NPV 99.5％.8处闭塞MRA诊断出7处,假阳性、假阴性各1处(分别是基底动脉和椎动脉颅内段).28段(24.6％)高估,7段低估.结论:对于判定50％、70％颅内动脉狭窄,3.0T 3D TOF MRA与旋转DSA相比具有较高的敏感性及特异性,可作为支架置入术前一种有效的检查手段.%Objective: To explore the reliability of 3D TOF MRA on 3.0T MR system for preoperative assessment of intracranial vascular stenosis. Methods: Thirty patients with intracranial arterial stenosis in the 2nd Hospital Affiliated to Harbin Medical University, who received both 3D TOF MRA on a 3.0T MR system and rotational digital subtraction angiography examinations. 450 vascular segments of the 30 patients were analysed. Without stenosis, mild stenosis (10%~<50%), stenosis of 50%, 70%, 100% as decision point to calculate sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRA. Results: Compared to DSA, 115 lesions were detected, the sensitivity and specificity were 87.0% and 99.7% for MRA in detecting stenosis. Take 50% as the critical point. The sensitivity and specificity was 86.7% and 99.5% respectively, the PPV was 92.9% and the NPV was 99.1%. Take 70% as the critical point the sensitivity and specificity was 95.5%, 99.5% respectively, PPV 91.3% and NPV 99.5%. MRA diagnosed 7 in the eight occlusions. One false positive and one false negative(that was stenosis of the basilar artery and intracranial segment of the vertebral artery). Twenty—eight(24.6%) segments were overestimated, 7 segments were underestimated. Conclusion: To determine 50% and 70% intracranial arterial stenosis, 3.0T 3D TOF MRA has high sensitivity and specificity compared to rotational DSA, and can be used as an effective means in pre—stenting surgery.
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