Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, 200233, China.
Eur Radiol. 2012 Jul;22(7):1404-12. doi: 10.1007/s00330-012-2390-9. Epub 2012 Mar 28.
To evaluate the clinical value of unenhanced magnetic resonance angiography (MRA) at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage (SAH).
A total of 165 patients with SAH were referred for three-dimensional time-of-flight MRA (3D-TOF-MRA) before digital subtraction angiography (DSA). For each aneurysm, 3D-TOF-MRA was used to determine whether the aneurysm was suitable for coil placement with or without balloon/stent-assisted coiling, surgical clipping or conservative treatment. Treatment planning with 3D-TOF-MRA was compared with actual treatment decisions or treatment that had been carried out in each aneurysm decided using DSA.
The aneurysm-based evaluation yielded accuracy of 96.9%, sensitivity of 97.6%, specificity of 93.1%, positive predictive value (PPV) of 98.8% and negative predictive value (NPV) of 87.1%, in the detection of intracranial aneurysms. Treatment planning could be correctly made on the basis of aneurysm anatomy and working view by volume rendering (VR) 3D-TOF-MRA with accuracy, sensitivity, specificity, PPV and NPV of 94.9%, 94.0%, 100%, 100% and 74.4%, respectively, on a per aneurysm-based evaluation.
VR 3D-TOF-MRA offers high diagnostic accuracy in the detection of ruptured intracranial aneurysms, and appears to be an effective treatment planning tool for most patients with SAH.
VR 3D-TOF-MRA offers high diagnostic accuracy for detecting ruptured intracranial aneurysms. • VR 3D-TOF-MRA helps treatment planning for patients with subarachnoid haemorrhage. • 3D-TOF-MRA is non-invasive and avoids using ionising radiation or contrast agents.
评估 3.0T 非增强磁共振血管成像（MRA）在蛛网膜下腔出血（SAH）患者诊断和治疗计划中的临床价值。
165 例 SAH 患者在数字减影血管造影（DSA）前接受三维时间飞跃 MRA（3D-TOF-MRA）检查。对于每个动脉瘤，使用 3D-TOF-MRA 来确定动脉瘤是否适合进行线圈放置，是否需要球囊/支架辅助线圈、手术夹闭或保守治疗。将 3D-TOF-MRA 的治疗计划与每个动脉瘤的实际治疗决策或已进行的治疗进行比较，这些决策是根据 DSA 决定的。
基于动脉瘤的评估在检测颅内动脉瘤方面的准确性为 96.9%，灵敏度为 97.6%，特异性为 93.1%，阳性预测值（PPV）为 98.8%，阴性预测值（NPV）为 87.1%。容积再现（VR）3D-TOF-MRA 可以根据动脉瘤的解剖结构和工作视图正确制定治疗计划，在每个动脉瘤的评估中，准确性、灵敏度、特异性、PPV 和 NPV 分别为 94.9%、94.0%、100%、100%和 74.4%。
VR 3D-TOF-MRA 在检测破裂颅内动脉瘤方面具有较高的诊断准确性，似乎是大多数 SAH 患者有效的治疗计划工具。
VR 3D-TOF-MRA 对检测破裂颅内动脉瘤具有较高的诊断准确性。VR 3D-TOF-MRA 有助于为蛛网膜下腔出血患者制定治疗计划。3D-TOF-MRA 是一种非侵入性的检查方法，避免了使用电离辐射或造影剂。
