摘要
目的通过对比分析双源CT血管造影(CTA)和MR三维快速自旋回波(3D-SPACE)序列对动脉粥样硬化(AS)斑块分型的评估能力,探讨两者在AS斑块评估中的应用价值。方法选取健康普通级雄性新西兰大白兔60只,随机分为试验组和对照组各30只,分别给予高脂饲料和普通饲料饲养20周,试验组在试验前给予两次药物触发。处死前均进行腹主动脉双源CTA和MR 3D-SPACE序列检查,以斑块病理结果为金标准,对比分析两种检查方法与病理结果的一致性及差异性。结果两种检查方法共发现斑块55处,与病理检查结果一致。其中Ⅳ型13处、Ⅴ型15处、Ⅵ型21处、Ⅷ型6处。二者评估Ⅳ型、Ⅴ型、Ⅵ型和Ⅷ型斑块的一致性分别为89.36%(Kappa=0.867,P<0.01)、88.56%(Kappa=0.842,P<0.01)、67.75%(Kappa=0.585,P<0.05)、61.18%(Kappa=0.467,P<0.05)。其中,MR 3D-SPACE序列鉴别Ⅵ型和Ⅷ型斑块能力明显优于双源CTA(P均<0.01)。结论双源CTA和MR 3D-SPACE序列均能够有效区分Ⅳ型、Ⅴ型斑块,但MR 3D-SPACE序列鉴别Ⅵ型和Ⅷ型斑块具有明显优势,两种方法联合应用于斑块的评估更具有临床价值。
Objective To evaluate the application of dual-source CTA and MR 3 D-SPACE sequences in the evaluation of atherosclerotic plaque classification,and to evaluate the value of both in the evaluation of the plaque. Methods Sixty healthy male New Zealand white rabbits were randomly divided into three groups: the experimental group and the control group. They were fed with high-fat diet and normal diet for 20 weeks. The plaque group was given two drug triggers before the experiment. The abdominal aorta dual-source CTA and MR 3 D-SPACE sequence were performed before sacrifice. The plaque pathological results were used as the gold standard. The consistency and difference between the two methods and pathological results were compared and analyzed. Results A total of 55 plaques were found in the two examination methods,which were consistent with the pathological examination results. There are 13 types of Ⅳ-,15 of Ⅴ type,21 of type Ⅵ,and 6 types of Ⅷ. The agreement between the two groups for the evaluation of type Ⅳ,Ⅴ,Ⅵ and Ⅷ plaques was 89.36%(Kappa=0.867,P<0.01),88.56%(Kappa=0.842,P<0.01),and 67.75%(Kappa= 0.585,P<0.05),61.18%(Kappa = 0.467,P< 0.05). Among them,MR 3 D-SPACE sequence identification type Ⅵ(positive rate = 85.71%,> dual source CTA 66.67%) and type Ⅷ(positive rate = 66.67%,> dual source CTA 50.00%) plaque ability is significantly better than dual source CTA(P<0.01). Conclusion Both the dual-source CTA and MR 3 D-SPACE sequences can effectively distinguish between type Ⅳ and type V plaques,but MR 3 D-SPACE sequences has significant advantages in distinguishing type Ⅵ and type Ⅷ plaques. There is more clinical value when the two methods are combined for plaque evaluation.
作者
李绍军
黄丙仓
杨晓丹
汪波
张申
梁雯雯
吴晶晶
杨慧
常时新
LI Shaojun;HUANG Bingcang;YANG Xiaodan(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2019年第11期2205-2209,共5页
Journal of Clinical Radiology
基金
上海市浦东新区科技发展基金(编号:PKJ2016-Y57)。
关键词
双源CTA
磁共振成像
三维快速自旋回波
动脉粥样硬化
Dual source CTA
Magnetic resonance
3D sampling perfertion with application optimized contrasts
Atherosclerosis
