Radiology and Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 561-756, Republic of Korea.
Eur Radiol. 2018 Sep;28(9):3840-3847. doi: 10.1007/s00330-018-5323-4. Epub 2018 Mar 19.
This study evaluated the utility of three-dimensional (3D), black-blood (BB), contrast-enhanced, magnetic resonance imaging (MRI) for the detection of intraluminal thrombi in acute stroke patients.
Forty-seven patients with acute stroke involving the anterior circulation underwent MRI examination within 6 h of clinical onset. Cerebral angiography was used as the reference standard. In a blinded manner, two neuroradiologists interpreted the following three data sets: (1) diffusion-weighted imaging (DWI) + 3D BB contrast-enhanced MRI; (2) DWI + susceptibility weighted imaging (SWI); (3) DWI + 3D BB contrast-enhanced MRI + SWI.
Of these patients, 47 had clots in the middle cerebral artery and four had clots in the anterior cerebral artery. For both observers, the area under the curve (Az) for data sets 1 and 3, which included 3D BB contrast-enhanced MRI, was significantly greater than it was for data set 2, which did not include 3D BB contrast-enhanced MR imaging (observer 1, 0.988 vs 0.904, p = 0.001; observer 2, 0.988 vs 0.894, p = 0.000).
Three-dimensional BB contrast-enhanced MRI improves detection of intraluminal thrombi compared to conventional MRI methods in patients with acute ischaemic stroke.
• BB contrast-enhanced MRI helps clinicians to assess the intraluminal clot • BB contrast-enhanced MRI improves detection of intraluminal thrombi • BB contrast-enhanced MRI for clot detection has a higher sensitivity.
本研究评估三维（3D）、黑血（BB）、对比增强磁共振成像（MRI）在急性卒中患者检测管腔内血栓中的应用价值。
47 例前循环急性卒中患者在发病后 6 小时内行 MRI 检查。以脑血管造影为参考标准。两位神经放射科医生以盲法分别分析以下三组数据：（1）弥散加权成像（DWI）+3D BB 对比增强 MRI；（2）DWI+磁敏感加权成像（SWI）；（3）DWI+3D BB 对比增强 MRI+SWI。
这些患者中，47 例大脑中动脉有血栓，4 例大脑前动脉有血栓。对于两位观察者，包含 3D BB 对比增强 MRI 的数据集 1 和 3 的曲线下面积（Az）明显大于不包含 3D BB 对比增强 MRI 的数据集 2（观察者 1：0.988 比 0.904，p = 0.001；观察者 2：0.988 比 0.894，p = 0.000）。
与常规 MRI 方法相比，3D BB 对比增强 MRI 可提高急性缺血性卒中患者管腔内血栓的检出率。
• BB 对比增强 MRI 有助于评估管腔内血栓• BB 对比增强 MRI 提高管腔内血栓的检出率• BB 对比增强 MRI 检测血栓的敏感性更高。
