Riles T S, Eidelman E M, Litt A W, Pinto R S, Oldford F, Schwartzenberg G W
Department of Surgery, New York University Medical Center, N.Y. 10016.
Stroke. 1992 Mar;23(3):341-6. doi: 10.1161/01.str.23.3.341.
To determine the accuracy of magnetic resonance angiography in assessing patients with cerebrovascular disease, we performed a study comparing the results of conventional cerebral angiography, duplex scanning, and magnetic resonance angiography.
From 42 patients, a total of 25 carotid arteries were evaluated by all three techniques. The studies were independently read and sorted into five categories according to the degree of stenosis: 0-15%, normal; 16-49%, mild; 50-79%, moderate; 80-99%, severe; and totally occluded.
Magnetic resonance angiography correlated exactly with conventional angiography in 39 arteries (52%); duplex scanning correlated with conventional angiography in 49 cases (65%). Compared with conventional angiography, both magnetic resonance angiography and duplex scanning tended to overread the degree of stenosis. The most critical errors associated with magnetic resonance angiography were three readings of total occlusion in vessels found to be patent on conventional angiograms.
Although magnetic resonance angiography offers great hope of providing high-quality imaging of the carotid artery with no risk and at less cost, data from this study suggest that misreading the degree of stenosis, or misinterpreting a stenosis for an occlusion, could lead to errors in clinical decisions. Guidelines for use of magnetic resonance angiography in a clinical setting are offered.
为了确定磁共振血管造影术在评估脑血管疾病患者中的准确性，我们进行了一项研究，比较了传统脑血管造影术、双功超声扫描和磁共振血管造影术的结果。
对42例患者的总共25条颈动脉采用这三种技术进行评估。这些研究由独立人员阅片，并根据狭窄程度分为五类：0 - 15%，正常；16 - 49%，轻度；50 - 79%，中度；80 - 99%，重度；完全闭塞。
磁共振血管造影术与传统血管造影术在39条动脉（52%）中结果完全相符；双功超声扫描与传统血管造影术在49例（65%）中结果相符。与传统血管造影术相比，磁共振血管造影术和双功超声扫描都倾向于高估狭窄程度。与磁共振血管造影术相关的最关键错误是在传统血管造影显示通畅的血管中有三次被读为完全闭塞。
尽管磁共振血管造影术为提供高质量的颈动脉成像带来了很大希望，且无风险、成本较低，但本研究数据表明，对狭窄程度的误读或把狭窄误判为闭塞可能导致临床决策失误。本文提供了在临床环境中使用磁共振血管造影术的指南。
