1.5T 3D—TOF—MRA与DSA诊断颅内动脉瘤的研究价值对比(1)
摘 要：目的 探讨三维时间飞跃法磁共振血管成像(3D-TOF-MRA)与数字减影血管造影(DSA)诊断颅内动脉瘤的研究价值。方法 收集20例经DSA及手术确诊为颅内动脉瘤患者，术前均行MRA及DSA检查。MRA检查后经MRP、MIP及VR法重建并与DSA结果进行对比。结果 20例患者DSA检查出23个动脉瘤，MRA VR重建检查出21个动脉瘤，检出率为91.30%，MPR及MIP检查出20个，检出率为87.00%。结论 1.5T 3D-TOF-MRA对颅内动脉瘤有较高的敏感性和准确性，为临床诊断及治疗提供了详细的参考价值，但对于微小动脉瘤存在一定的漏诊现象，应选择DSA进行进一步检查。
关键词：颅内动脉瘤；核磁共振；三维时间飞越法血管成像；数字血管成像
中图分类号：R739.41 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.052
文章编号：1006-1959(2018)07-0150-03
, 百拇医药
Comparison of the Value of 1.5T 3D-TOF-MRA and DSA in Diagnosing Intracranial Aneurysms
LAN Ying-yong
(Department of Radiology，the Second Affiliated Hospital of Guangxi University of Science and Technology，Liuzhou 545000，Guangxi，China)
Abstract：Objective To evaluate the value of three-dimensional time leaps magnetic resonance angiography(3D-TOF-MRA)and digital subtraction angiography(DSA)in the diagnosis of intracranial aneurysms.Methods 20 patients with intracranial aneurysms confirmed by DSA and operation were examined by MRA and DSA before operation.After MRA examination，the results were compared with the results of MRP，MIP，and VR and the results of DSA.Results In 20 patients，23 aneurysms were detected by DSA， and 21 aneurysms were detected by MRA VR reconstruction.The detection rate was 91.30%，and 20 were detected by MPR and MIP. The detection rate was 87.00%.Conclusion 1.5T 3D-TOF-MRA has high sensitivity and accuracy for the diagnosis and treatment of intracranial aneurysms，which provides a detailed reference for clinical diagnosis and treatment.However，there is a certain missed diagnosis for small aneurysms.DSA should be further examined.
, 百拇医药
Key words：Intracranial aneurysm；Nuclear magnetic resonance；Three-dimensional time-of-flight imaging；Digital angiography
自發性蛛网膜下腔出血(subarachnoid hemorrhage，SAH)最主要的原因是颅内动脉瘤破裂，占全部蛛网膜下腔出血病例的80.00%，其致死率及致残率高达30%～45%和50%[1]，选择最合适的影像学检查方法并尽早及时治疗是挽救患者生命的关键。数字减影血管造影(digital subtraction angiography，DSA)是诊断颅内动脉瘤金标准，但其有侵入性、辐射性、相对昂贵及形成动脉夹层并发症等缺点，不适用于所有患者或多次检查。1.5T磁共振血管成像(MRA)作为DSA术前影像检查评估的一种重要辅助补充方式，可有效提高颅内动脉瘤的检出率。
1资料与方法
, 百拇医药
1.1一般资料 收集2014年12月～2016年12月广西科技大学第二附属医院收治的经DSA证实的颅内动脉瘤患者20例，男13例，女7例，年龄17～75岁，平均年龄(48.61±1.02)岁。临床表现：蛛网膜下腔出血15例，头痛3例，动眼神经麻痹及视力下降2例。
1.2检查方法 磁共振成像使用GE 1.5T MR扫描仪。使用标准头部相控阵线圈，分别在层面选择和读出方向上施加流动补偿，静脉饱和，施加TONE脉冲技术。扫描序列参数：T1WI序列TR/TE=1795 ms/20.4 ms，T2WI为TR/TE=4432 ms/134.8 ms，层厚6.0 mm，层间距2.0 mm，行横轴位及矢状位T1及T2加权像扫描。MRA血管成像用3D TOF血管成像法，选用4个成像容积块技术，每块32层，层厚1.4 mm，TR/TE=29 ms/6.8 ms，翻转角20°，扫描时间200 s。扫描范围包括从颈动脉分叉部至颅顶。血管造影机为飞利浦Allura Xper FD大C臂DSA机，采用Seldinger法穿刺股动脉，进行全脑血管造影。, 百拇医药(蓝英勇)
关键词：颅内动脉瘤；核磁共振；三维时间飞越法血管成像；数字血管成像
中图分类号：R739.41 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.052
文章编号：1006-1959(2018)07-0150-03
, 百拇医药
Comparison of the Value of 1.5T 3D-TOF-MRA and DSA in Diagnosing Intracranial Aneurysms
LAN Ying-yong
(Department of Radiology，the Second Affiliated Hospital of Guangxi University of Science and Technology，Liuzhou 545000，Guangxi，China)
Abstract：Objective To evaluate the value of three-dimensional time leaps magnetic resonance angiography(3D-TOF-MRA)and digital subtraction angiography(DSA)in the diagnosis of intracranial aneurysms.Methods 20 patients with intracranial aneurysms confirmed by DSA and operation were examined by MRA and DSA before operation.After MRA examination，the results were compared with the results of MRP，MIP，and VR and the results of DSA.Results In 20 patients，23 aneurysms were detected by DSA， and 21 aneurysms were detected by MRA VR reconstruction.The detection rate was 91.30%，and 20 were detected by MPR and MIP. The detection rate was 87.00%.Conclusion 1.5T 3D-TOF-MRA has high sensitivity and accuracy for the diagnosis and treatment of intracranial aneurysms，which provides a detailed reference for clinical diagnosis and treatment.However，there is a certain missed diagnosis for small aneurysms.DSA should be further examined.
, 百拇医药
Key words：Intracranial aneurysm；Nuclear magnetic resonance；Three-dimensional time-of-flight imaging；Digital angiography
自發性蛛网膜下腔出血(subarachnoid hemorrhage，SAH)最主要的原因是颅内动脉瘤破裂，占全部蛛网膜下腔出血病例的80.00%，其致死率及致残率高达30%～45%和50%[1]，选择最合适的影像学检查方法并尽早及时治疗是挽救患者生命的关键。数字减影血管造影(digital subtraction angiography，DSA)是诊断颅内动脉瘤金标准，但其有侵入性、辐射性、相对昂贵及形成动脉夹层并发症等缺点，不适用于所有患者或多次检查。1.5T磁共振血管成像(MRA)作为DSA术前影像检查评估的一种重要辅助补充方式，可有效提高颅内动脉瘤的检出率。
1资料与方法
, 百拇医药
1.1一般资料 收集2014年12月～2016年12月广西科技大学第二附属医院收治的经DSA证实的颅内动脉瘤患者20例，男13例，女7例，年龄17～75岁，平均年龄(48.61±1.02)岁。临床表现：蛛网膜下腔出血15例，头痛3例，动眼神经麻痹及视力下降2例。
1.2检查方法 磁共振成像使用GE 1.5T MR扫描仪。使用标准头部相控阵线圈，分别在层面选择和读出方向上施加流动补偿，静脉饱和，施加TONE脉冲技术。扫描序列参数：T1WI序列TR/TE=1795 ms/20.4 ms，T2WI为TR/TE=4432 ms/134.8 ms，层厚6.0 mm，层间距2.0 mm，行横轴位及矢状位T1及T2加权像扫描。MRA血管成像用3D TOF血管成像法，选用4个成像容积块技术，每块32层，层厚1.4 mm，TR/TE=29 ms/6.8 ms，翻转角20°，扫描时间200 s。扫描范围包括从颈动脉分叉部至颅顶。血管造影机为飞利浦Allura Xper FD大C臂DSA机，采用Seldinger法穿刺股动脉，进行全脑血管造影。, 百拇医药(蓝英勇)