联合对比增强磁共振血管造影和相位对比磁共振成像在疑似锁骨下动脉窃血综合征中的诊断效能

Diagnostic Performance of Combined Contrast-Enhanced Magnetic Resonance Angiography and Phase-Contrast Magnetic Resonance Imaging in Suspected Subclavian Steal Syndrome.

作者信息

Tsao Teng-Fu, Cheng Kai-Lun, Shen Chao-Yu, Wu Ming-Chi, Huang Hsin-Hui, Su Chun-Hung, Chen Fong-Lin, Tyan Yeu-Sheng, Lin Yung-Chang

机构信息

Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan, Republic of China; Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China.

Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China; School of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan, Republic of China.

出版信息

Can Assoc Radiol J. 2016 May;67(2):190-201. doi: 10.1016/j.carj.2015.08.007. Epub 2016 Jan 30.

DOI:10.1016/j.carj.2015.08.007

PMID:26831732

Abstract

PURPOSE

The study sought to evaluate the efficacy of magnetic resonance imaging (MRI) in patients with suspected subclavian steal syndrome (SSS) using both contrast-enhanced (CE) MR angiography and phase-contrast (PC) MRI.

METHODS

Fifteen suspected SSSs from 13 patients were evaluated using CE-MR angiography and PC-MRI. Ten patients also received dynamic CE-MR angiography.

RESULTS

All MRI examinations were technically successful. By combining CE-MR angiography with PC-MRI, 10 SSSs were diagnosed in 9 patients. The delay enhancement dynamic technique predicted SSS with a sensitivity, specificity, and accuracy of 57.1%, 100%, and 72.7%, respectively. Without the dynamic technique, affected delay-enhanced arteries were poorly visualized and could be mistaken for occluded vessels. Retrograde vertebral flow by PC-MRI was used to predict ipsilateral SSS with a sensitivity, specificity, and accuracy of 100%, 60%, and 86.7%, respectively. There were 2 false positives including 1 patient with a proximal total occlusion of the affected vertebral artery and another with brachiocephalic steal syndrome rather than SSS. This suggested that retrograde vertebral flow does not always indicate SSS.

CONCLUSIONS

CE-MR angiography combined with PC-MRI is efficacious when evaluating SSS in clinical practice.

摘要

目的

本研究旨在通过对比增强磁共振血管造影（CE-MRA）和相位对比磁共振成像（PC-MRI）评估磁共振成像（MRI）对疑似锁骨下动脉盗血综合征（SSS）患者的疗效。

方法

对13例患者的15例疑似SSS进行了CE-MRA和PC-MRI评估。10例患者还接受了动态CE-MRA检查。

结果

所有MRI检查在技术上均获成功。通过将CE-MRA与PC-MRI相结合，在9例患者中诊断出10例SSS。延迟增强动态技术预测SSS的敏感性、特异性和准确性分别为57.1%、100%和72.7%。在没有动态技术的情况下，延迟增强的受累动脉显示不佳，可能被误认为是闭塞血管。PC-MRI显示的椎动脉逆向血流用于预测同侧SSS，其敏感性、特异性和准确性分别为100%、60%和86.7%。有2例假阳性，其中1例患者受累椎动脉近端完全闭塞，另1例患有头臂干盗血综合征而非SSS。这表明椎动脉逆向血流并不总是提示SSS。