摘要
目的分析7.0 T高分辨血管壁成像(high resolution vessel wall imaging,HR-VWI)对缺血性脑卒中患者大脑中动脉(middle cerebral artery,MCA)粥样硬化性狭窄程度评估的准确性和可重复性。材料与方法回顾性纳入我院2022年9月至2023年11月期间于我院确诊为MCA粥样硬化性狭窄的患者47例,2周内分别完成7.0 T HR-VWI和数字减影血管造影成像(digital subtraction angiography,DSA)检查。两名高年资医师对所有患者MCA粥样硬化斑块处的最狭窄直径、狭窄长度、最狭窄处内外壁面积以及其近端正常血管直径、内外壁面积分别进行独立测量,利用组内相关系数(intraclass correlation coefficient,ICC)分析组内、组间测量一致性;由一名高年资神经介入医师在DSA图中测量MCA粥样硬化斑块处最大狭窄率和狭窄长度,并与HR-VWI测量均值进行Bland-Atman和相关性分析。结果两名观察者分别独自测量了47名患者69处最狭窄处,其管腔直径均值为(1.19±0.49)mm、斑块长度均值为(6.12±3.06)mm、内外壁面积均值分别为(1.88±1.11)mm^(2)、(8.99±2.49)mm^(2),斑块近端正常管腔直径均值为(2.31±0.35)mm、内外壁面积均值为(4.74±1.31)mm^(2)、(10.54±2.44)mm^(2),所有测量结果一致性分析结果ICC均大于0.8,P≤0.001;在DSA与HR-VWI测量最大狭窄率和狭窄长度的Bland-Altman一致性分析中,94.74%(54/57)和96.49%(55/57)的差异值位于差异均值±1.96标准差之间,ICC分别为0.944和0.897,两种方法在狭窄率和狭窄长度方面具有很强的相关性(狭窄率:r=0.955,P<0.001;狭窄长度:r=0.890,P<0.001)。结论7.0 T HR-VWI在缺血性脑卒中患者MCA粥样硬化性狭窄程度评估中具有较好的准确性和可重复性。
Objective:To analyze the accuracy and reproducibility of 7.0 T high resolution vessel wall imaging(HR-VWI)in assessing the degree of atherosclerotic stenosis in the middle cerebral artery(MCA)patients with ischemic stroke.Materials and Methods:The present study retrospectively collected data from a total of 47 patients diagnosed with atherosclerosis in the middle cerebral artery at our hospital from September 2022 to November 2023.All patients underwent 7.0 T HR-VWI and digital subtraction angiography(DSA)examinations within 2 weeks.Two senior physicians independently measured the stenosis diameter,stenosis length,inner and outer wall areas at the site of the atherosclerotic plaques in the MCA patients,and the intra-observer and inter-observer consistency was assessed using intra-class correlation coefficient(ICC).The stenotic rate and length of the MCA vessel affected by atherosclerotic plaque are measured by an experienced interventional neurologist,followed by conducting Bland-Altman analysis and correlation analysis to compare these measurements with the mean value obtained through HR-VWI.Results:The mean lumen diameter at the most stenotic site was independently measured by two observers for all 47 patients[(1.19±0.49)mm].Additionally,measurements were also taken for mean plaque length(6.12±3.06 mm),mean inner wall area[(1.88±1.11)mm^(2)],mean outer wall area[(8.99±2.49)mm^(2)],mean normal lumen diameter[(2.31±0.35)mm],and mean inner wall area[(4.74±1.31)mm^(2)]as well as mean outer wall area[(10.54±2.44)mm^(2)].The ICC values for all measurement was greater than 0.8,and the P value was less than 0.001.In the Bland-Altman analysis of consistency between DSA and HR-VWI in measuring stenotic rate and stenotic length,a high percentage of difference values fell within the mean difference±1.96 standard deviations:94.74%(54/57)for stenotic rate and 96.49%(55/57)for stenotic length,with ICC values of 0.944 and 0.897,respectively.Furthermore,strong correlations were observed between the two methods regarding both stenotic rate and stenotic length(r=0.955,P<0.001;r=0.890,P<0.001).Conclusions:The 7.0 T HR-VWI demonstrates excellent reproducibility and accuracy in evaluating the degree of atherosclerotic stenosis in the MCA among patients with ischemic stroke.
作者
何敏
邓亚利
黎川
甄志铭
左朦
王健
陈伟
陈炜
陈家飞
HE Min;DENG Yali;LI Chuan;ZHEN Zhiming;ZUO Meng;WANG Jian;CHEN Wei;CHEN Wei;CHEN Jiafei(T Magnetic Resonance Translation Medicine Research Center,Department of Radiology,Southwest Hospital,Army Medical University(Third Military Medical University),Chongqing 400038,China;Department of Neurology,Southwest Hospital,Army Medical University(Third Military Medical University),Chongqing 400038,China;MR Research Collaboration Teams,Siemens Healthineers Ltd.,Guangzhou 510620,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2024年第12期42-47,共6页
Chinese Journal of Magnetic Resonance Imaging
基金
重庆市社会事业与民生保障科技创新专项重点研发项目(编号:cstc2017shms-zdyfX0015)
陆军军医大学第一附属医院7T磁共振专项基金项目(编号:20247TZD01)。
关键词
大脑中动脉
粥样硬化性狭窄
缺血性脑卒中
高分辨血管壁成像
磁共振成像
7.0
T
数字减影血管造影成像
middle cerebral artery
atherosclerotic stenosis
cerebral arterial thrombosis
high resolution vessel wall imaging
magnetic resonance imaging
7.0 T
digital subtraction angiography
