天津医药

天津医药 ›› 2022, Vol. 50 ›› Issue (2): 205-209.doi: 10.11958/20211670

• 应用研究 • 上一篇    下一篇

触发式非对比增强磁共振血管成像诊断下肢静脉曲张价值探讨

许团新，刘晓，朱刚明，吴绍腾，刘成康，杨概，叶沛豪
  

  1. 东莞东华医院放射科（邮编523110）
  • 收稿日期:2021-07-19 修回日期:2021-10-03 出版日期:2022-02-15 发布日期:2022-02-15
  • 通讯作者: 朱刚明 E-mail:aming955@163.com
  • 作者简介:统计截图见二修
  • 基金资助:
    东莞市社会科技发展一般项目（202050715046901）

A pilot study on the value of triggered non-contrast enhanced MRI angiography in the diagnosis of varicose veins of lower extremities

XU Tuanxin, LIU Xiao, ZHU Gangming, WU Shaoteng, LIU Chengkang, YANG Gai, YE Peihao #br#   

  1. Department of Radiology, Dongguan Tungwah Hospital, Dongguan 523110, China
  • Received:2021-07-19 Revised:2021-10-03 Published:2022-02-15 Online:2022-02-15

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摘要： 目的 探讨触发式非对比增强（TRANCE）磁共振血管成像用于诊断下肢静脉曲张（VV）的临床应用价值。 方法 30例入组的下肢VV患者（41段静脉）行TRANCE磁共振血管成像及多普勒超声（DUS）检查，对下肢VV最明 显处信号比值（SR）与管径比值（VDR）行Pearson相关性分析。对2位医生及2周前后的TRANCE影像Likert评分一 致性进行评价。以数字减影血管造影（DSA）结果为金标准，评估2种检查方法诊断效能及一致性。结果 下肢静脉 SR与VDR呈负相关（r=-0.440，P＜0.05）。盆腔段较大腿段整体Likert评分降低（P＜0.05），大腿段和小腿段差异无 统计学意义。2位医生对盆腔段、大腿段及小腿段2周前和2周后的Likert评分以及同一位医生2周前和2周后的 Likert 评分均具有较好的一致性。TRANCE 与 DUS 诊断 41 段 VV 的敏感度分别为 94.59%、86.49%，特异度分别为 50.00%、75.00%，准确度分别为90.24%、85.37%，两者诊断结果Kappa值为0.617，一致性较好。结论 TRANCE磁共 振成像用于VV定量分析的诊断效能及与DUS的一致性较好，且影像质量良好，可作为术前辅助检查手段。

关键词: 静脉曲张, 血管造影术, 数字减影, 超声检查, 多普勒, 磁共振血管成像, 触发式非对比增强磁共振血管成像

Abstract: Objective To investigate the clinical application of triggered non-contrast enhanced (TRANCE) magnetic resonance imaging in varicose veins (VV) of lower extremities. Methods Thirty patients with 41 segments of veins were examined by TRANCE and Doppler ultrasonography (DUS). Pearson correlation analysis was used to analyze the signal ratio (SR) and vessel diameter ratio (VDR) of VV. The Likert score consistency of TRANCE images was evaluated between the two doctors and between before and after 2 weeks. The digital subtraction angiography (DSA) was used as the gold standard, the diagnostic efficiency and consistency of the two inspection methods were evaluated. Results SR was negatively correlated with VDR (r=-0.440，P＜0.05). The overall Likert score was lower in the pelvic segment than that of thigh segment (P＜ 0.05), and there was no significant difference in Likert scores between the thigh and calf segments. The two doctors had good consistency in Likert scores of the pelvic, thigh, and calf segments before and after 2 weeks, and the Likert scores elevated by the same doctor before and after 2 weeks. With surgical results as the gold standard, the sensitivity of TRANCE and DUS of 41 segments of VV were 94.59% and 86.49%, the specificity were 50.00% and 75.00%, and the accuracy were 90.24% and 85.37%, respectively. The diagnostic efficiency kappa value of the two methods was 0.617, indicating good consistency. Conclusion TRANCE can quantitatively analyze the degree of VV and has good image quality in the diagnosis of lower extremity varicose veins, and the diagnostic efficiency is consistent with DUS. It can be used as an important preoperative auxiliary examination method.

Key words: varicose veins, angiography, digital subtraction, ultrasonography, doppler, magnetic resonance angiography, triggered non-contrast enhanced magnetic resonance angiography