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目的通过与数字减影血管造影(DSA)比较,评价MR黑血运动致敏驱动平衡改良技术(improved motionsensitized driven equilibrium,iMSDE)序列在诊断颈动脉狭窄中的临床价值。方法对32例患者的39支粥样硬化狭窄性颈动脉进行DSA及黑血iMSDE成像,比较两者在评估狭窄处最小管腔直径、狭窄处斑块累及长度、斑块破溃和判断最大狭窄部位的差异。结果黑血iMSDE成像与DSA相比:在判断颈动脉最大狭窄部位有较好的一致性(Kappa值=0.894);狭窄处最小管腔直径无显著性差异[(3.3±0.9)mm vs(3.2±0.8)mm,P=0.098];黑血iMSDE成像所示狭窄处斑块累及长度明显大于DSA[(21.9±5.6)mm vs(15.3±3.4)mm,P<0.001];黑血iMS-DE成像与DSA显示斑块破溃一致性较好。结论磁共振黑血iMSDE成像能清晰显示颅外段颈动脉管壁结构和粥样斑块的形态,并为临床提供较可靠和有价值的信息。
Objective To evaluate the clinical value of improved motionsensitized driven equilibrium (iMSDE) in the diagnosis of carotid artery stenosis by comparing with digital subtraction angiography (DSA). Methods Thirty-nine atherosclerotic stenosis carotid arteries of 32 patients underwent DSA and black blood iMSDE imaging. The differences between the two groups in assessing the minimal lumen diameter at stenosis, the plaque length at stenosis, the plaque rupture, and the maximum stenosis Parts of the difference. Results Compared with DSA, the iMSDE images of black blood showed a good consistency in judging the largest stenosis of carotid artery (Kappa = 0.894); there was no significant difference in the smallest lumen diameter of stenosis [(3.3 ± 0.9) mm vs (3.2 ± 0.8) mm, P = 0.098]. The length of plaque involvement in stenosis was significantly greater in iMSDE than in DSA [(21.9 ± 5.6) mm vs (15.3 ± 3.4) mm, P <0.001] Imaging and DSA showed plaque rupture better consistency. Conclusion Magnetic resonance imaging of iMSDE can clearly show the structure of the extracranial carotid artery wall and atherosclerotic plaque, and provide more reliable and valuable information for clinical diagnosis.