Li Jing, Wang Jue, Wei Xiao-Er, Zhao Yu-Wu, Wang Feng, Li Yue-Hua
Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
Front Neurosci. 2020 Feb 11;14:71. doi: 10.3389/fnins.2020.00071. eCollection 2020.
To explore structural variations of the circle of Willis using three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA), and to compare this modality with digital subtraction angiography (DSA). A total of 819 consecutive patients suspected of having cerebral vascular diseases underwent 3D-TOF-MRA, followed by DSA within 2 weeks. We report accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 3D-TOF-MRA compared with DSA. The sensitivity and specificity of combined analyses were 90-100 and 98-100%, respectively. The sensitivity and NPV of 3D-TOF-MRA images for A-, C-, D-, and H-types of circle of Willis anomalies were 100%. The specificity, accuracy and sensitivity were all 100% for detecting absence of the anterior communicating artery (ACOA). Sensitivity, specificity, PPV, and NPV were all 100% for detecting F-type. The sensitivity and PPV of volume rendered (VR) images for the B-, E-, and G-types were relatively low (85.0, 86.2, and 73.8%, respectively). Maximum intensity projection (MIP) was somewhat better (88.3, 89.2, and 81.8%, respectively). Combined analyses were better still (95.8, 96.1, and 99.0%, respectively). Specificity and NPVs were high (99.3-100%). 3D-TOF-MRA compares well to DSA for evaluation of the structure of the circle of Willis. As 3D-TOF-MRA is a non-invasive modality, it may be preferred as a means to evaluate structural variations of the circle of Willis.
利用三维时间飞跃磁共振血管造影（3D - TOF - MRA）探索 Willis 环的结构变异，并将该方法与数字减影血管造影（DSA）进行比较。共有819例连续怀疑患有脑血管疾病的患者接受了3D - TOF - MRA检查，随后在2周内进行了DSA检查。我们报告了3D - TOF - MRA与DSA相比的准确性、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。联合分析的敏感性和特异性分别为90 - 100%和98 - 100%。3D - TOF - MRA图像对 Willis 环A、C、D和H型异常的敏感性和NPV均为100%。检测前交通动脉（ACOA）缺如时，特异性、准确性和敏感性均为100%。检测F型时，敏感性、特异性、PPV和NPV均为100%。容积再现（VR）图像对B、E和G型的敏感性和PPV相对较低（分别为85.0%、86.2%和73.8%）。最大密度投影（MIP）稍好一些（分别为88.3%、89.2%和81.8%）。联合分析更好（分别为95.8%、96.1%和99.0%）。特异性和NPV较高（99.3 - 100%）。在评估 Willis 环结构方面，3D - TOF - MRA与DSA效果相当。由于3D - TOF - MRA是一种非侵入性方法，它可能更适合作为评估 Willis 环结构变异的手段。
