南方医科大学学报2011，Vol.31Issue(3)：385-391,7.
斜矢状位黑血MRI增强扫描对颈动脉内膜剥脱手术的术前评估
Oblique-sagittal black-blood contrast-enhanced magnetic resonance imaging in preoperative evaluation for carotid endarterectomy
摘要
Abstract
To evaluate the value of oblique-sagittal black-blood contrast-enhanced magnetic resonance imaging (OB-CEMRI) in atherosclerotic carotid artery (CA) assessment before carotid endarterectomy (CEA). Methods Twenty-five patients with symptomatic atherosclerotic stenosis in the carotid artery (involving 26 arteries) were scheduled for CEA. OB-CEMRI and digital subtraction angiography (DSA) were conducted within 1 week prior to CEA, and two radiologists independently assessed the location of maximal lumen stenosis, plaque rupture, degree of maximal lumen stenosis and plaque involvement on DSA and OB-CEMRI images. The differences of DSA and the OB-CEMRI in analyzing the plaque conditions were assessed in comparison with matched histological sections of the excised specimens. Results Compared with the corresponding histological specimens, both DSA (κ -0.807) and OB-CEMRI (κ=0.812) showed a good consistency in defining the location of the maximal lumen stenosis. OB-CEMRI showed a better performance in detecting plaque rupture with higher sensitivity (90.0%) and specificity (83.3%) than DSA (40.0% and 66.7%, respectively). No significant difference was found between DSA and the OB-CEMRI in evaluating the degree of maximal lumen stenosis [(77.33 ± 3.79)% vs (76.02 ± 3.95)%, P=0.648]. Compared with the histological examination, OB-CEMRI appeared to underestimate the stenosis. The plaque extent on OB-CEMRI was larger than that on DSA (18.96±4.96 mm vs 14.80±3.78 mm, P-0.004), and similar to that by histological examination (18.13±4.57 mm, P-0.506). Conclusions OB-CEMRI allows noninvasive and objective detection of the location of the maximal lumen stenosis, plaque rupture, and plaque extent, though with a lower accuracy than DSA in the assessment of the maximal lumen stenosis. OB-CEMRI combined with DSA offers a more reliable means for preoperative evaluation of the carotid artery plaques for CEA.关键词
粥样硬化/颈动脉/磁共振成像/数字减影血管造影/内膜剥脱术Key words
atherosclerosis/ carotid artery/ magnetic resonance imaging/ angiography, digital subtraction/ endarterectomy分类
医药卫生引用本文复制引用
王庆军,王勇,蔡剑鸣,赵廷强,马林,蔡幼铨,陈利峰,王湛博..斜矢状位黑血MRI增强扫描对颈动脉内膜剥脱手术的术前评估[J].南方医科大学学报,2011,31(3):385-391,7.基金项目
教育部留学回国人员启动基金(2007-hyb-001) （2007-hyb-001）
