1.5T中场强磁共振血管成像诊断脑血管狭窄的分析OA
Analysis of 1.5T Medium-Field Magnetic Resonance Angiography in the Diagnosis of Cerebrovascular Stenosis
目的:探讨 1.5T 中场强磁共振血管成像(MRA)在缺血性脑血管病(ICVD)颅内血管狭窄诊断中的临床应用效果,为基层医院 ICVD 的血管检查提供实用参考.方法:回顾性选取 2024 年 6 月—2025 年 12 月大冶市人民医院神经内科一病区收治的108 例 ICVD 患者为研究对象,所有患者均完成颅脑 1.5T 中场强 MRA 及全脑数字减影血管造影(DSA)检查,以 DSA 为金标准,对比 1.5T 中场强 MRA 对颅内责任大血管狭窄的诊断效能,分析其诊断狭窄率≥50％血管的正确率、灵敏度、特异度等效能指标.结果:1.5T 中场强 MRA 可清晰多方位显示颅内大血管形态,其对血管狭窄程度的诊断与 DSA 具有极高一致性(Kappa=0.8093),且MRA 测量狭窄率均不低于 DSA 测量值;针对狭窄率≥50％的血管,1.5T 中场强 MRA 诊断正确率 94.4％、灵敏度 100％、特异度53.8％、阳性预测率 94.1％、阴性预测率 100％.结论:1.5T 中场强 MRA 操作无创、普及性高,在 ICVD 颅内血管狭窄诊断中具有较高临床价值,可作为基层医院 ICVD 患者脑血管狭窄的术前预检和初筛手段,对轻度血管狭窄患者可替代 DSA 检查,为基层临床诊疗提供可靠依据,但诊断重度血管狭窄时可能出现过高评估,需DSA 检查明确.
Objective:To explore the clinical application effect of 1.5T medium-field strong magnetic resonance angiography(MRA)in the diagnosis of intracranial vascular stenosis in ischemic cerebrovascular disease(ICVD),and to provide practical references for vascular examination of ICVD in primary hospitals.Method:A retrospective selection was made of 108 patients with ICVD admitted to the First Ward of Neurology of Daye People's Hospital from June 2024 to December 2025 as the research subjects.All patients completed 1.5T strong MRA of the brain and digital subtraction angiography(DSA)of the whole brain.DSA was taken as the gold standard.The diagnostic efficacy of 1.5T medium-intensity MRA for intracranial stenosis of major responsible vessels was compared,and the accuracy rate,sensitivity,specificity and other efficacy indicators for diagnosing vessels with a stenosis rate of≥50％were analyzed.Result:The 1.5T midfield strong MRA can clearly and multi-directional display the morphology of intracranial large blood vessels.Its diagnosis of the degree of vascular stenosis is highly consistent with that of DSA(Kappa=0.8093),and the stenosis rate measured by MRA is not lower than that measured by DSA.For blood vessels with a stenosis rate of≥50％,the diagnostic accuracy of 1.5T medium-intensity MRA was 94.4％,the sensitivity was 100％,the specificity was 53.8％,the positive predictive rate was 94.1％,and the negative predictive rate was 100％.Conclusion:The 1.5T mid-field strong MRA operation is non-invasive and highly popular.It has high clinical value in the diagnosis of intracranial vascular stenosis in ICVD and can be used as a preoperative pre-examination and initial screening method for cerebral vascular stenosis in ICVD patients in primary hospitals.For patients with mild vascular stenosis,it can replace DSA examination and provide reliable basis for clinical diagnosis and treatment at the primary level.However,overestimation may occur when diagnosing severe vascular stenosis,and a DSA examination is required for confirmation.
陈光学;胡明超;叶鹏飞
大冶市人民医院 湖北 大冶 435100大冶市人民医院 湖北 大冶 435100大冶市人民医院 湖北 大冶 435100
1.5T中场强磁共振血管成像数字减影血管造影缺血性脑血管病颅内血管狭窄诊断效能
1.5T medium-field magnetic resonance angiographyDigital subtraction angiographyIschemic cerebrovascular diseaseIntracranial vascular stenosisDiagnostic efficacy
《中外医学研究》 2026 (20)
79-82,4
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