中国卒中杂志2017，Vol.12Issue(4)：320-326,7.DOI:10.3969/j.issn.1673-5765.2017.04.006
BPAS-MRI在椎-基底动脉颅内段夹层鉴别诊断中的应用
The Application of Intracranial Vertebrobasilar Artery Dissection Differential Diagnosis with BPAS-MRI
张桂莲 1朱新业 2马珠琳 1李晓会 3张秋娟 3陈敬菊 1滕国良 4刘娇 1李涛 1王何莹1
作者信息
- 1. 710004 西安 西安交通大学第二附属医院神经内科
- 2. 西安交通大学第二附属医院急诊科
- 3. 西安交通大学第二附属医院影像科
- 4. 西安市北方医院神经内科
- 折叠
摘要
Abstract
Objective To explore the effect of combining a new MRI technique named basi-parallel anatomic scanning (BPAS)-magnetic resonance (MR) imaging with time-of-flight (TOF)-MR angiography (MRA) in the diagnosis of differentiating intracranial vertebrobasilar artery dissection (VBD). Methods Radiologists and radiographer in the Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University explored and acquired BPAS scanning parameters suitable for 3.0-MR scanning and image processing according to the screening criteria in the reference of BPAS. A total of 142 patients who underwent BPAS-MR imaging and 3D TOF-MRA in inpatient and outpatient neurology department, including clinical suspected diagnosis of 20 cases of VBD, 60 cases of atherosclerotic narrowing, and 62 cases of hypoplastic arteries, were retrospectively analyzed. MRA and BPAS images were analyzed by two readers blinded to the patients' clinical data. Receiver Operating Characteristic (ROC) curves were performed to compare the capability of conventional MRA with and without BPAS imaging in suspected VBD cases. The consistency of diagnosis results of 2 observers were also evaluated. Results The area under the curve was increased significantly by combining BPAS imaging findings with MRA (0.93 vs 0.70, 0.96 vs 0.75, P<0.01, respectively by reader No.1 and No.2). In addition, the sensitivity was 100% for both readers and significantly greater than MRA (55%, 60% for both readers, P<0.01). However, specificities were not significantly different (86.89% vs 85.25%, P=0.85; 92.62% vs 90.16%, P=0.65). The consistency of diagnosis results of 2 observers was excellent (Kappa=0.85). Conclusion Combining BPAS and MRA can accurately evaluate the intracranial vertebrobasilar condition through revealing the surface appearance of artery, and differentiate VBD from atherosclerosis or hypoplasia, and provide evidence for corresponding treatments.关键词
BPAS-MRI/椎-基底动脉颅内段/动脉夹层/鉴别诊断Key words
BPAS-MRI/Vertebrobasilar intracranial artery/Artery dissection/Differential diagnosis引用本文复制引用
张桂莲,朱新业,马珠琳,李晓会,张秋娟,陈敬菊,滕国良,刘娇,李涛,王何莹..BPAS-MRI在椎-基底动脉颅内段夹层鉴别诊断中的应用[J].中国卒中杂志,2017,12(4):320-326,7.
