目的 分析7.0 T 高分辨血管壁成像(high resolution vessel wall imaging,HR-VWI)对缺血性脑卒中患者大脑中动脉(middle cerebral artery,MCA)粥样硬化性狭窄程度评估的准确性和可重复性.材料与方法 回顾性纳入我院2022年9月至2023年11月期间于我院确诊为MCA粥样硬化性狭窄的患者47例,2周内分别完成7.0 T HR-VWI和数字减影血管造影成像(digital subtraction angiography,DSA)检查.两名高年资医师对所有患者MCA粥样硬化斑块处的最狭窄直径、狭窄长度、最狭窄处内外壁面积以及其近端正常血管直径、内外壁面积分别进行独立测量,利用组内相关系数(intraclass correlation coefficient,ICC)分析组内、组间测量一致性;由一名高年资神经介入医师在DSA图中测量MCA粥样硬化斑块处最大狭窄率和狭窄长度,并与HR-VWI测量均值进行Bland-Atman和相关性分析.结果 两名观察者分别独自测量了47名患者69处最狭窄处,其管腔直径均值为(1.19±0.49)mm、斑块长度均值为(6.12±3.06)mm、内外壁面积均值分别为(1.88±1.11)mm2、(8.99±2.49)mm2,斑块近端正常管腔直径均值为(2.31±0.35)mm、内外壁面积均值为(4.74±1.31)mm2、(10.54±2.44)mm2,所有测量结果一致性分析结果ICC均大于0.8,P≤0.001;在DSA与HR-VWI测量最大狭窄率和狭窄长度的Bland-Altman一致性分析中,94.74%(54/57)和96.49%(55/57)的差异值位于差异均值±1.96标准差之间,ICC分别为0.944和0.897,两种方法在狭窄率和狭窄长度方面具有很强的相关性(狭窄率:r=0.955,P<0.001;狭窄长度:r=0.890,P<0.001).结论 7.0 T HR-VWI在缺血性脑卒中患者MCA粥样硬化性狭窄程度评估中具有较好的准确性和可重复性.
Assessment of middle cerebral artery atherosclerotic stenosis by 7.0 T MR HR-VWI:A consistency analysis with DSA
Objective:To analyze the accuracy and reproducibility of 7.0 T high resolution vessel wall imaging(HR-VWI)in assessing the degree of atherosclerotic stenosis in the middle cerebral artery(MCA)patients with ischemic stroke.Materials and Methods:The present study retrospectively collected data from a total of 47 patients diagnosed with atherosclerosis in the middle cerebral artery at our hospital from September 2022 to November 2023.All patients underwent 7.0 T HR-VWI and digital subtraction angiography(DSA)examinations within 2 weeks.Two senior physicians independently measured the stenosis diameter,stenosis length,inner and outer wall areas at the site of the atherosclerotic plaques in the MCA patients,and the intra-observer and inter-observer consistency was assessed using intra-class correlation coefficient(ICC).The stenotic rate and length of the MCA vessel affected by atherosclerotic plaque are measured by an experienced interventional neurologist,followed by conducting Bland-Altman analysis and correlation analysis to compare these measurements with the mean value obtained through HR-VWI.Results:The mean lumen diameter at the most stenotic site was independently measured by two observers for all 47 patients[(1.19±0.49)mm].Additionally,measurements were also taken for mean plaque length(6.12±3.06 mm),mean inner wall area[(1.88±1.11)mm2],mean outer wall area[(8.99±2.49)mm2],mean normal lumen diameter[(2.31±0.35)mm],and mean inner wall area[(4.74±1.31)mm2]as well as mean outer wall area[(10.54±2.44)mm2].The ICC values for all measurement was greater than 0.8,and the P value was less than 0.001.In the Bland-Altman analysis of consistency between DSA and HR-VWI in measuring stenotic rate and stenotic length,a high percentage of difference values fell within the mean difference±1.96 standard deviations:94.74%(54/57)for stenotic rate and 96.49%(55/57)for stenotic length,with ICC values of 0.944 and 0.897,respectively.Furthermore,strong correlations were observed between the two methods regarding both stenotic rate and stenotic length(r=0.955,P<0.001;r=0.890,P<0.001).Conclusions:The 7.0 T HR-VWI demonstrates excellent reproducibility and accuracy in evaluating the degree of atherosclerotic stenosis in the MCA among patients with ischemic stroke.
万方数据
维普
