三维对比增强MR评估颈动脉狭窄程度的临床研究

摘要

目的 评估三维对比增强核磁共振血管造影(Three dimensional contrast enhanced magnetic resonance angiography 3D CEMRA)诊断颈动脉狭窄的应用价值.方法 36例拟诊颈动脉狭窄的患者同时行颈动脉数字剪影血管造影(Digital subtraction angiography DSA)和3D CEMRA检查,以DSA为诊断颈动脉狭窄的金标准,应用统计软件Meta-DiSc1.4计算3D CEMRA诊断颈动脉狭窄的敏感性、特异性和受试者工作曲线(receiver operating characteriseic ROC)下面积.结果 3D CEMRA诊断颈动脉狭窄56处,DSA诊断54处,两种诊断方法检出率无差别(x2,P=0.65)；以DSA为诊断金标准,3D CEMRA诊断颈动脉狭窄的敏感性为0.80(95CI:0.68～0.89)特异性为0.99(0.98～1.00)ROC曲线下面积为0.95.结论 3D CEMRA诊断颈动脉敏感性和特异性均较高,在某种程度上可以替代DSA.%Objective To evaluate the value of three-dimensional contrast enhanced magnetic resonance angiography (3D CEMRA) in carotid stenosis. Methods 36 patients suspected with carotid stenosis were examined by DSA and 3D CEMRA. The sensitivity, specificity and receiver operaing characteristic curves (ROC) were calculated to assess the diagnostic value of individual diagnostic tests. Results There was no difference for carotid stenosis detection between the DSA and 3D CEMRA (54 vs 56, x2 ,P=0. 65). The sensitivity, specificity ROC curve of 3D CEMRA were 0. 80(95CI; 0. 68~0. 89) ,0. 99(0. 98-1. 00)and 0. 95, respectively. Conclusion 3D CEMRA has high sensitivity and specificity for diagnosis of carotid stenosis, and it can take place of DAS in some degree.