Radiology Department, The First Affiliated Hospital of Soochow University, Shizi Street 188#, Suzhou, Jiangsu Province, 215006, PR China.
Radiology Department, The First Affiliated Hospital of Soochow University, Shizi Street 188#, Suzhou, Jiangsu Province, 215006, PR China.
Clin Radiol. 2019 Oct;74(10):817.e1-817.e7. doi: 10.1016/j.crad.2019.06.018. Epub 2019 Aug 12.
To evaluate the feasibility of high-resolution magnetic resonance imaging (MRI) with a simultaneous non-contrast angiography and intraplaque haemorrhage (SNAP) sequence in identifying cervical artery dissections (CeAD).
Fifty-three patients with suspected CeAD underwent the SNAP sequence (including non-contrast magnetic resonance angiography [MRA] and heavy T1-weighting vessel wall images simultaneously in a single scan) and conventional MRI sequences (including three-dimensional [3D] time-of-flight MRA and T1-weighted black-blood imaging [T1W BB]) and cervical vascular ultrasound (CVUS). In diagnosis of CeAD, the diagnostic sensitivity and specificity of SNAP, and the diagnostic coherence between SNAP and conventional sequences and between SNAP and CVUS was analysed. At follow-up, the absolute signal (AS) and signal index (SI) of the intramural haematoma (IMH) between vessel wall images on SNAP and T1W-BB images were compared. The image quality of SNAP was analysed by comparing the signal-to-noise ratio (SNR) between vessel wall images from the SNAP and T1W-BB sequences.
The SNAP sequence was found to provide good performance in the diagnosis of CeAD (sensitivity 72.2%, specificity 98.2%); good agreement was found between SNAP and conventional sequences (Cohen's κ=0.76, p<0.05); and excellent agreement was found between SNAP and CVUS (Cohen's κ=0.83, p<0.05). There was no significant difference between AS or SI of the IMH of the vessel wall images within the SNAP and T1W-BB sequences during the review. The SNAP sequence had higher SNR of the IMH compared to T1W-BB, T2W-BB, proton-density-weighted volume isotropic turbo-spin-echo acquisition imaging (PD-VISTA) sequences (p<0.05).
The SNAP sequence holds the potential to be preferred choice for screening of patients with a high suspicion of CeAD and for the follow-up of IMH after treatment.
评估高分辨率磁共振成像（MRI）联合非对比血管成像和斑块内出血（SNAP）序列识别颈内动脉夹层（CeAD）的可行性。
53 例疑似 CeAD 的患者行 SNAP 序列（单次扫描同时进行非对比磁共振血管造影[MRA]和重 T1 加权血管壁成像）和常规 MRI 序列（包括三维[3D]时间飞跃 MRA 和 T1 加权黑血成像[T1W BB]）及颈部血管超声（CVUS）检查。SNAP 序列诊断 CeAD 的诊断灵敏度和特异度，SNAP 与常规序列之间以及 SNAP 与 CVUS 之间的诊断一致性进行分析。随访时，比较 SNAP 血管壁图像与 T1W-BB 图像的腔内血肿（IMH）绝对信号（AS）和信号指数（SI）。通过比较 SNAP 和 T1W-BB 序列血管壁图像的信噪比（SNR）来分析 SNAP 的图像质量。
SNAP 序列在诊断 CeAD 方面表现良好（灵敏度 72.2%，特异性 98.2%）；SNAP 与常规序列之间具有良好的一致性（Cohen's κ=0.76，p<0.05）；SNAP 与 CVUS 之间具有极好的一致性（Cohen's κ=0.83，p<0.05）。在随访中，SNAP 和 T1W-BB 序列的血管壁图像内 IMH 的 AS 或 SI 无显著差异。与 T1W-BB、T2W-BB、质子密度加权容积各向同性涡轮自旋回波采集成像（PD-VISTA）序列相比，SNAP 序列的 IMH 具有更高的 SNR（p<0.05）。
SNAP 序列有望成为高度怀疑 CeAD 患者筛查和治疗后 IMH 随访的首选方法。
