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改良时间飞跃磁共振静脉造影在髂静脉压迫综合征诊断中的效果。

Efficacy of modified time of flight magnetic resonance venography in diagnosis of iliac vein compression syndrome.

机构信息

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Eur J Radiol. 2023 Sep;166:111020. doi: 10.1016/j.ejrad.2023.111020. Epub 2023 Jul 31.

Abstract

OBJECTIVE

We investigated the diagnostic efficacy of modified time of flight magnetic resonance venography (mTOF-MRV) for iliac vein compression syndrome diagnosis by optimizing the scanning parameters and improving image quality.

METHODS

A retrospective study was conducted on 69 patients who underwent routine time of flight magnetic resonance venography (TOF-MRV) and 85 patients who received mTOF-MRV. Assessment of image quality of the two methods was performed by two radiologists using a four-point method. The sensitivity, specificity, positive and negative predictive values of TOF-MRV and mTOF-MRV in the diagnosis of significant iliac vein compression (stenosis >50%) were analyzed by calculating the iliac vein stenosis rates of the two methods and using digital subtraction angiography (DSA) as the gold standard.

RESULTS

Inter-observer assessment of objective data measurement revealed excellent agreement {ICC [95% confidence interval (CI)]: 0.972 (0.953 to 0.983) for TOF-MRV and 0.979 (0.965 to 0.988) for m-TOF MRV, 0.976 (0.960 to 0.986) for DSA}. The mean error of stenosis rate of mTOF-MRV was markedly smaller than that of TOF-MRV (p < 0.05). Sensitivity, specificity, positive and negative predictive values of TOF-MRV in the diagnosis of significant stenosis were 100%, 95%, 67% and 100%, respectively. The sensitivity, specificity, positive and negative predictive values of mTOF-MRV were 100%. The mean image score for the mTOF-MRV was 3.63 ± 0.59, which was significantly higher compared with that of TOF-MRV (2.19 ± 0.42).

CONCLUSION

mTOF-MRV has better image quality and can accurately diagnose venous stenosis. Therefore, it can be used for the detection of iliac vein compression syndrome and further assessment after endovascular interventions.

摘要

目的

通过优化扫描参数和改善图像质量,研究改良时间飞越磁共振静脉造影(mTOF-MRV)对髂静脉压迫综合征诊断的诊断效能。

方法

回顾性分析 69 例行常规时间飞越磁共振静脉造影(TOF-MRV)和 85 例行 mTOF-MRV 的患者。两位放射科医生采用 4 分法评估两种方法的图像质量。通过计算两种方法的髂静脉狭窄率,并以数字减影血管造影(DSA)为金标准,分析 TOF-MRV 和 mTOF-MRV 诊断髂静脉狭窄(狭窄率>50%)的敏感性、特异性、阳性预测值和阴性预测值。

结果

客观数据测量的观察者间评估显示极好的一致性(TOF-MRV 的 ICC[95%置信区间(CI)]:0.972(0.953 至 0.983),m-TOF-MRV 的 ICC:0.979(0.965 至 0.988),DSA 的 ICC:0.976(0.960 至 0.986))。mTOF-MRV 狭窄率的平均误差明显小于 TOF-MRV(p<0.05)。TOF-MRV 诊断显著狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为 100%、95%、67%和 100%,mTOF-MRV 的敏感性、特异性、阳性预测值和阴性预测值均为 100%。mTOF-MRV 的平均图像评分为 3.63±0.59,明显高于 TOF-MRV(2.19±0.42)。

结论

mTOF-MRV 具有更好的图像质量,能准确诊断静脉狭窄,可用于髂静脉压迫综合征的检测和血管内介入治疗后的进一步评估。

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