本文選題：頸動(dòng)脈　切入點(diǎn)：磁共振血管成像　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的評(píng)估Time-SLIP血管成像的成像質(zhì)量,評(píng)價(jià)Time-SLIP、CE-MRA以及DSA在頸動(dòng)脈狹窄度評(píng)估方面的差異。資料與方法1.35例具有頸動(dòng)脈斑塊的患者先后使用磁共振進(jìn)行Ti me-SLI P和CE-MRA掃描,其中1 0例患者3天后進(jìn)一步行頸動(dòng)脈DS A檢查。2.在獲取Ti me-SLI P和CE-MRA頸動(dòng)脈血管圖像后分別由兩位副高級(jí)影像診斷醫(yī)師對(duì)每幅圖像質(zhì)量、組織污染情況進(jìn)行技術(shù)評(píng)分。3.并對(duì)Time-SLIP、CE-MRA顯示的血管數(shù)量進(jìn)行評(píng)價(jià)。4.對(duì)其中進(jìn)行過(guò)DS A檢查的1 0例患者,以NASCET法計(jì)算上述三種方法顯示的頸動(dòng)脈血管狹窄率。結(jié)果1.兩位診斷醫(yī)師對(duì)圖像質(zhì)量、組織污染及血管數(shù)量評(píng)價(jià)的一致性較高,Kappa值均0.80。2.35例患者,Time-SLIP組和CE-MRA組中,圖像質(zhì)量為3分以上者分別占94.2%、97.1%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3.組織污染評(píng)分小于等于1分者分別占88.6%、82.9%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4.雙側(cè)頸總動(dòng)脈及主要分支總共210條血管,Time-SLIP和CE-MRA分別顯示兩側(cè)頸總動(dòng)脈、頸內(nèi)動(dòng)脈及頸外動(dòng)脈血管數(shù)為199/210條和202/210條,其符合率分別為94.8%和96.2%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。5.其中10例患者,以DS A診斷為金標(biāo)準(zhǔn),頸動(dòng)脈狹窄Ti me-SLI P診斷的敏感性92.31%,特異性97.87%,準(zhǔn)確性96.67%;CE-MRA診斷的敏感性100%,特異性97.87%,準(zhǔn)確性98.33%;以DSA為標(biāo)準(zhǔn)兩者顯示狹窄的血管數(shù)為47/60、46/60,兩者差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論1.Time-SLIP與CE-MRA在圖像質(zhì)量、組織污染、顯示血管數(shù)量上具有較高的一致性。2.Time-SLIP用于頸動(dòng)脈狹窄評(píng)估有較高的準(zhǔn)確度。3.由于Ti me-SLI P技術(shù)無(wú)需對(duì)比劑的優(yōu)勢(shì),能夠廉價(jià)、無(wú)創(chuàng)的提示管腔狹窄程度,因此其對(duì)于臨床有較高的應(yīng)用前景。目的對(duì)比磁共振常規(guī)檢查技術(shù)(T1WI、T2WI、PDWI)、磁敏感加權(quán)成像(SWI)、彌散加權(quán)成像(DWI)的圖像質(zhì)量。評(píng)價(jià)磁敏感加權(quán)成像、彌散加權(quán)成像在頸動(dòng)脈斑塊出血、早期炎癥方面的應(yīng)用價(jià)值。資料與方法1.40例經(jīng)超聲診斷有頸動(dòng)脈斑塊的患者先后使用磁共振進(jìn)行磁共振常規(guī)檢查技術(shù)(T1WI、T2WI、PDWI)和磁敏感加權(quán)成像(SWI)、彌散加權(quán)成像(DWI)的軸位掃描。2.5種序列圖像分別由兩位副高級(jí)醫(yī)師對(duì)每幅圖像質(zhì)量情況進(jìn)行技術(shù)評(píng)分,對(duì)具有診斷價(jià)值的圖像進(jìn)行評(píng)估。3.判斷有無(wú)頸動(dòng)脈斑塊出血或早期炎癥。結(jié)果1.40例患者中,其中T1WI、T2WI、PDWI、SWI、DWI組中,圖像質(zhì)量為3分以上者分別占90.0%、91.3%、92.5%、87.5%、88.8%,5個(gè)序列均具有診斷價(jià)值的有35例患者,兩位診斷醫(yī)師的一致性較高,Kappa值均0.80,5種方法的圖像質(zhì)量差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.磁共振常規(guī)檢查技術(shù)及SWI、DWI分別診斷斑塊出血例數(shù)分別為8、17、9例,三種檢查技術(shù)相互比較,SWI與磁共振常規(guī)序列及DWI檢測(cè)斑塊出血之間差異具有統(tǒng)計(jì)學(xué)意義。磁共振常規(guī)檢查技術(shù)及DWI分別診斷斑塊炎癥例數(shù)分別為4、11例,兩種檢查技術(shù)相互比較,DWI與磁共振常規(guī)序列檢測(cè)斑塊早期炎癥之間差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論1.SWI顯示頸動(dòng)脈斑塊出血優(yōu)于常規(guī)序列和DWI,DWI與常規(guī)序列基本一致。2.DWI顯示頸動(dòng)脈斑塊早期炎癥優(yōu)于磁共振常規(guī)檢查序列。3.三種序列結(jié)合,能夠更好的發(fā)現(xiàn)頸動(dòng)脈斑塊出血及早期炎癥情況,判斷斑塊易損性,預(yù)警腦卒中。
[Abstract]:Objective to evaluate the imaging quality evaluation, Time-SLIP angiography, Time-SLIP, CE-MRA and DSA in different degree of carotid stenosis assessment. Materials and methods 1.35 cases of patients with carotid artery plaque has the use of magnetic resonance Ti me-SLI P and CE-MRA scanning, including 10 cases of patients with carotid artery 3 days after further DS A examination.2. in access Ti me-SLI and P CE-MRA respectively after carotid artery vascular images by two deputy senior radiologist on each image quality, organization pollution technical score and.3. of Time-SLIP, the number of vascular CE-MRA showed 10 cases of DS evaluation of.4. A examination on the patients with carotid artery by the method of NASCET calculation shows the above three methods. Results 1. stenosis rate of two physicians on the image quality, the number of organizations and pollution evaluation of vascular high consistency, the Kappa values were 0.80.2.35 patients, Time-SLIP Group and CE-MRA group, the image quality for more than 3 points were respectively 94.2%, 97.1%, the difference was not statistically significant (P0.05).3. pollution score less than equal to 1 points accounted for 88.6%, 82.9%, the difference was not statistically significant (P0.05.4.) bilateral common carotid artery and branches a total of 210 vessels, Time-SLIP and CE-MRA respectively on both sides of the common carotid artery, external carotid artery and internal carotid artery blood vessel number of neck for 199/210 and 202/210, and the coincidence rate were 94.8% and 96.2%, the difference was not statistically significant (P0.05.5.) in 10 patients with DS, A diagnosis as the gold standard, Ti me-SLI P in the diagnosis of carotid artery stenosis and the sensitivity was 92.31%, specificity 97.87%, the accuracy was 96.67%; the sensitivity of 100% CE-MRA diagnosis, specificity of 97.87%, accuracy of 98.33%; with DSA as the standard two shows the number of vascular stenosis was 47/60,46/60, the difference was not statistically significant (P0.05). Conclusion 1.Time-SLIP and CE-MRA in image The quality of the organization, pollution, show that the consistency of.2.Time-SLIP has higher accuracy for the number of blood vessels on the.3. have a higher evaluation of carotid artery stenosis due to Ti me-SLI P without contrast agent advantage, to cheap, no stenosis of a prompt, so it has high application prospect in clinical. Objective to compare MRI check technology (T1WI, T2WI, PDWI), susceptibility weighted imaging (SWI), diffusion weighted imaging (DWI). The image quality evaluation of susceptibility weighted imaging, diffusion weighted imaging in carotid artery plaque hemorrhage, application value of early inflammation. Materials and methods 1.40 cases of ultrasound diagnosis of patients with carotid artery plaque has the use of magnetic resonance MRI routine examination (T1WI, T2WI, PDWI Technology) and susceptibility weighted imaging (SWI), diffusion weighted imaging (DWI) axial scan.2.5 sequences respectively by two associate senior doctor Technical score of each image quality evaluation,.3. to determine the presence of carotid plaque hemorrhage or early inflammation of the image has a high diagnostic value. Results in 1.40 patients, including T1WI, T2WI, PDWI, SWI, DWI group, the image quality was more than 3 points were respectively 90%, 91.3%, 92.5%. 87.5%, 88.8%, 5 series have diagnostic value in 35 patients and two physicians of the high consistency, no statistically significant differences in image quality Kappa value method 0.80,5 (P0.05).2. MRI examination technique and SWI, DWI respectively in diagnosis of plaque hemorrhage cases were 8,17,9 cases, three inspection technology comparison, with statistical significance SWI and MRI conventional sequences and DWI detection of plaque hemorrhage differences. Routine MRI examination and diagnosis were DWI plaque inflammation cases were 4,11 cases, two kinds of inspection techniques are compared with each other, and magnetic DWI There was statistically significant difference between the conventional resonance sequence detection of plaque inflammation. Conclusion early 1.SWI showed carotid artery plaque hemorrhage is superior to the conventional sequence and DWI sequence, DWI and conventional.2.DWI display consistent carotid plaque inflammation is better than that of routine MRI examination in early three with the sequence of.3. sequence, and better able to find early inflammation of carotid plaque hemorrhage judgment, plaque vulnerability, warning stroke.

【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R543.4;R445.2

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