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目的:对照分析后循环缺血患者椎基底动脉的3D-TOP-MRA和DSA检查结果,探讨3D-TOP-MRA用于后循环缺血的诊断价值。方法:选取80例后循环缺血患者分别完成椎基底动脉的3D-TOP-MRA和DSA检查,以盲法判断动脉血管的狭窄情况,对比分析两种方法检测结果间的相关性,并系统评价3D-TOP-MRA的诊断效率。结果:以DSA为金标准,3D-TOP-MRA检测出狭窄血管的总体灵敏度为88.23%,轻度、中度、重度狭窄和闭塞的灵敏度分别为57.89%、96.30%、85.71%和100%。3D-TOP-MRA检查出狭窄血管总体特异度为66.67%,轻度、中度、重度狭窄和闭塞的特异度分别为100%、96.23%、92.42%和100%。3D-TOP-MRA检查出狭窄血管的总体准确度为85.00%,轻度、中度、重度狭窄和闭塞的准确度分别为90.00%、96.25%、91.25%和100%。结论:3D-TOP-MRA无创检测后循环缺血患者椎基底动脉的狭窄有较高的准确度和灵敏度,特别是中重度狭窄病例,可作为血管狭窄术前筛查、术后随访重要检查手段,有利于控制后循环缺血诊治过程中的临床风险。
OBJECTIVE: To analyze the 3D-TOP-MRA and DSA findings of vertebrobasilar artery in patients with ischemic circulation after ischemia and to evaluate the diagnostic value of 3D-TOP-MRA for posterior circulation ischemia. Methods: Eighty patients with posterior circulation ischemia were enrolled in the study. 3D-TOP-MRA and DSA of vertebrobasilar artery were performed respectively. The stenosis of arterial vessels was judged by blinded method. The correlation between the two methods was analyzed and compared systematically Diagnostic efficiency of 3D-TOP-MRA. Results: The sensitivity of 3D-TOP-MRA was 88.23%. The sensitivities of mild, moderate, severe stenosis and occlusion were 57.89%, 96.30%, 85.71% and 100% respectively. The overall specificity of stenotic vessels was 66.67% by 3D-TOP-MRA. The specificity of mild, moderate, severe stenosis and occlusion was 100%, 96.23%, 92.42% and 100% respectively. The overall accuracy of 3D-TOP-MRA in detecting stenosed vessels was 85.00%. The accuracy of mild, moderate, severe stenosis and occlusion was 90.00%, 96.25%, 91.25% and 100% respectively. Conclusion: 3D-TOP-MRA noninvasive detection of vertebrobasilar artery stenosis patients with high accuracy and sensitivity, especially in severe stenosis, can be used as a preoperative stenosis of vascular stenosis, postoperative follow-up of important means of examination , Is conducive to control the clinical risk in the diagnosis and treatment of posterior circulation ischemia.