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目的探讨三维容积各向同性快速自旋回波(3D-VISTA)技术在大脑中动脉狭窄中的诊断价值。方法对37例经MR血管造影(MRA)或CT血管造影(CTA)诊断的大脑中动脉M1段不同程度狭窄或闭塞的患者进行3D-VISTA进一步检查,并与介入治疗时的数字减影血管造影(DSA)检查进行对比,计算3D-VISTA及DSA检查的血管狭窄率,同时观察狭窄处管壁在3D-VISTA上的图像特点。结果 37例患者有33支大脑中动脉的3D-VISTA图像质量符合测量要求,与DSA测量的血管狭窄率相关性好(r=0.943,P<0.01),以DSA作为金标准,两者一致性较高(Kappa值0.86,P<0.01)。在3D-VISTA图像上表现为狭窄的27支大脑中动脉中,21支出现管壁偏心性增厚,3支环形增厚;另有1支向心性增厚并环形强化,2支管壁仅见狭窄改变。结论 3D-VISTA在大脑中动脉狭窄的诊断方面与DSA相比有良好的一致性和相关性,并且可以提供狭窄处管壁的相关信息,对大脑中动脉狭窄病因的鉴别提供一定的帮助。
Objective To investigate the diagnostic value of three-dimensional volume isotropic fast spin echo (3D-VISTA) in the diagnosis of middle cerebral artery stenosis. Methods Thirty-seven patients with different degrees of stenosis or occlusion of the middle cerebral artery diagnosed by MR angiography (MRA) or CT angiography (CTA) were further examined by 3D-VISTA and compared with digital subtraction angiography (DSA). The 3D-VISTA and DSA were used to calculate the stenosis rate of the vessel, and the images of the wall of the stenosis at 3D-VISTA were observed. Results The 3D-VISTA images of 33 middle cerebral arteries of 37 patients met the measurement requirements and had good correlation with the stenosis rate of DSA (r = 0.943, P <0.01). Using DSA as the gold standard, the consistency between the two Higher (Kappa value 0.86, P <0.01). Of the 27 middle cerebral arteries that were narrow in the 3D-VISTA image, 21 had eccentric wall thickening, 3 had annular thickening, and 1 had concentric thickening and annular enhancement, with only 2 wall Narrow changes. Conclusion 3D-VISTA has good consistency and correlation with DSA in the diagnosis of middle cerebral artery stenosis, and can provide information about the wall of the stenosis, which can help to identify the cause of middle cerebral artery stenosis.