摘要
目的探究磁共振成像(MRI)联合64排螺旋CT(64-MSCT)检查对烟雾病的诊断效能。方法选取2019年4月至2021年4月于本院就诊的65例疑似烟雾病患者为研究对象,分别进行MRI检查、64-MSCT检查、数字减影血管造影(DSA)检查,统计各检查诊断结果,以DSA检查结果为“金标准”,采用受试者工作特征曲线(ROC)分析MRI联合64-MSCT检查的诊断符合率、诊断效能。结果65例疑似烟雾病患者,经DSA检查55例患者颅底血管网呈现增粗、迂曲及扩张症状,确诊为烟雾病,MRI检查46例患者见颅底异常血管网,诊断符合率为70.77%,Kappa值为0.587,而64-MSCT检查49例患者见颅底异常血管网,诊断符合率75.38%,Kappa值为0.612,MRI和64-MSCT检查诊断符合率及Kappa值均无统计学意义(P>0.05);MRI联合64-MSCT检查诊断符合率达83.08%,Kappa值为0.785,分别高于MRI和64-MSCT诊断符合率(P<0.05);ROC曲线分析显示,MRI检查诊断烟雾病的约登指数0.719,曲线下面积(AUC)为0.748[95%CI(0.725,0.837)],敏感度90.63%,特异度81.25%,准确度70.77%;64-MSCT检查诊断烟雾病的约登指数0.729,AUC为0.761[95%CI(0.728,0.859)],敏感度94.29%,特异度78.57%,准确度75.38%;MRI联合64-MSCT检查诊断烟雾病的约登指数0.855,AUC为0.813[95%CI(0.738,0.877)],敏感度97.30%,特异度88.24%,准确度83.08%。结论MRI联合64-MSCT检查具有较高诊断效能,可有效提高烟雾病诊断符合率,具有极高的应用价值。
Objective To investigate the effect of magnetic resonance imaging(MRI)and 64-slice spiral computed tomography(64-MSCT)on the diagnostic coincidence rate for patients with moyamoya disease.Meth-ods In total,65 patients with suspected moyamoya disease admitted to our hospital between April 2019 and April 2021 were selected as study subjects.MRI,64-MSCT,and digital subtraction angiography(DSA)exami-nations were performed and the diagnostic results of each examination were evaluated.The DSA results were regarded as the reference standard.Receiver operating characteristics(ROC)curves were used to analyze the diagnostic coincidence rate and diagnostic efficiency of MRI and 64-MSCT examinations alone and in com-bination.Results In 65 patients suspected with moyamoya disease,DSA examinations showed thickening,tor-tuosity,and dilatation of the skull base vascular network in 55 patients;these findings confirmed moyamoya disease.MRI examinations showed an abnormal skull base vascular network in 46 patients,providing a diagnostic coincidence rate of 70.77%and a Kappa value of 0.587.The 64-MSCT examinations showed an abnormal skull base vascular network in 49 patients,providing a diagnostic coincidence rate of 75.38%and a Kappa value of 0.612.The MRI and 64-MSCT examinations showed no statistically significant difference in diagnostic coinci-dence rate and Kappa value(P>0.05).The diagnostic coincidence rate of MRI combined with 64-MSCT was 83.08%and the Kappa value was 0.785,values that were significantly higher than those of either of the modalities alone(P<0.05).ROC curve analysis showed that the Youden index,area under the curve(AUC),sensitivity,specificity,and accuracy of MRI for diagnosing moyamoya disease were 0.719,0.748[95%CI(0.725,0.837)],90.63%,81.25%,and 70.77%,respectively,while the corresponding values for 64-MSCT were 0.729,0.761[95%CI(0.728,0.859)],94.29%,78.57%,and 75.38%,respectively.For MRI and 64-MSCT combined,the Youden index,AUC,sensitivity,specificity,and accuracy were 0.855,0.813[95%CI(0.738,0.877)],97.30%,88.24%,and 83.08%,respectively.Conclusion MRI and 64-MSCT combined have high diagnostic efficiency for moyamoya disease,and can effectively improve the diagnostic rate for moyamoya disease over either of the modalities alone.
作者
刘俊
Liu Jun(Department of MRI Room,Xinxiang Medical College,Zhongmou People′s Hospital,Zhengzhou 451450,China)
出处
《实用医技杂志》
2022年第4期371-374,共4页
Journal of Practical Medical Techniques
关键词
脑底异常血管网病
诊断
磁共振成像
Moyamoya disease
Diagnosis
Magnetic resonance imaging
