高分辨率磁共振和彩色多普勒超声诊断颈动脉斑块的比较研究

A Comparative Study between High-resolution MRI and Color Doppler Ultrasound in Diagnosing Carotid Artery Plaques

中文关键词: 斑块  动脉粥样硬化  颈动脉狭窄  磁共振成像  超声检查  多普勒  彩色

英文关键词: plaque  atherosclerotic  carotid stenosis  magnetic resonance imaging (MRI)  ultrasonography  Doppler  color

中文摘要:

      目的 比较高分辨率亮血及黑血磁共振与彩色多普勒超声评估颈动脉斑块及颈动脉狭窄的诊断价值.方法 对102例临床怀疑存在颅外颈动脉狭窄的患者同时行高分辨率亮血及黑血磁共振检查与彩色多普勒超声检查(其中35例1月内行数字化减影血管造影术),根据病变狭窄程度分为1～4级,进行2种检查方法的相关性比较,并以数字化减影血管造影术作为金标准,分析其诊断的准确性.结果 超声与高分辨率磁共振诊断血管狭窄程度的相关性密切(Rs=0.95,P＜0.01).高分辨率磁共振诊断≥50％狭窄的敏感性、特异性和准确度分别为94.6％、100％和99.0％,而超声分别为89.2％、100％和98.1％.另外超声未能分析出3例斑块的表面溃疡.结论 高分辨率磁共振和彩色多普勒超声联合应用可以提高颈动脉斑块的检出及狭窄程度的诊断准确性,预防缺血性脑卒中的发生.

英文摘要:

      Objective To compare the diagnostic value of high-resolution bright-blood and black-blood MRI with that of color Doppler ultrasound in the evaluation of carotid artery plaques and carotid stenosis.Methods Both high-resolution bright-blood and black-blood MRI and color Doppler ultrasound examinations were performed to 102 suspicious cases,out of the 102,35 cases received digital substraction angiography (DSA) within 1 month;the stenosis was graded into 4,(Degree 1,2,3 and 4);the correlation between the 2 imaging techniques was studied and their diagnostic accuracy was analyzed,taking DSA as the golden standard.Result There existed a close correlation between ultrasound and high-resolution MRI in diagnosing the degrees of artery stenosis (Rs =0.95,P＜ 0.01);the sensitivity,specificity and accuracy of high-resolution MRI in diagnosing over 50％ artery stenosis were 94.6％,100％ and 99.0％ respectively while those of ultrasound were 89.2％,100％ and 98.1％ respectively;ultrasound examination failed to find out the superficial ulcers of 3 plaques.Conclusion The combined application of high-resolution MRI and color Doppler ultrasound can raise the accuracy in diagnosing carotid artery plaques and the degrees of artery stenosis,which is of great help in preventing the occurrence of ischemic stroke.