南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (10): 1402-.

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3.0 T高分辨率磁共振成像评估大脑中动脉粥样硬化狭窄的可信度

贾泽军，袁渊，杨志刚，赵瑞，许奕，黄清海，赵文元，马小龙，邓晓群，洪波，刘建民   

  • 出版日期:2014-10-20 发布日期:2014-10-20

Inter- and intra-observer reproducibility of 3.0 T high-resolution magnetic resonance
imaging for evaluating atherosclerotic stenosis in the middle cerebral artery

  • Online:2014-10-20 Published:2014-10-20

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摘要： 目的探讨3.0 T高分辨率磁共振成像（HR MRI）评估大脑中动脉粥样硬化性狭窄的可信度。方法2011年2月~2013年
12月，对66例经DSA确诊的动脉粥样硬化性MCAM1段中重度狭窄（50%~99%）患者进行HR MRI检查，测定MCA最狭窄处
管腔面积（lumen area, LAnarrow）、血管面积（vessel area, VAnarrow）及参考血管LAreference及VAreference，分析MCA斑块分布部位（前壁、后
壁、上壁、下壁）；比较2位研究者的定量测量及定性分析结果，对比分析其中一位研究者首次及1个月后的再次分析结果；ICC
法分析观察者自身差异及不同观察者间差异。结果HR MRI测量VAnarrow、VAreference、LAreference具有非常好的组间（ICC 0.801、
0.843、0.808）及组内一致性（ICC 0.811、0.916、0.958）；LAnarrow测定结果的一致性一般（ICC 0.584、0.625），要差于其他3个指标。
HR MRI判断有无斑块的一致性非常好（ICC 0.917、0.960）；HR M RI判定MCA不同部位（上壁、下壁、前壁、后壁）斑块的组间
（ICC 0.856、0.836、0.791、0.905）、组内（ICC 0.876、0.827、0.825、0.950）一致性较好。结论基于HR MRI的MCA粥样硬化性狭
窄定量、定性分析具有较好的可重复性，但对血管最狭窄处的定量分析可信度仍有待提高。

Abstract: Objective To assess the reproducibility of 3.0 T high-resolution magnetic resonance imaging (HR MRI) for evaluation
of atherosclerotic stenosis in the middle cerebral artery (MCA). Methods From February, 2011 to December, 2013, 66
consecutive patients with MCA-M1 atherosclerotic stenosis (50%-99%) confirmed by digital subtractive angiography (DSA)
received examinations with 3.0 T HR MRI for measurement of the vessel area (VA) and lumen area (LA) at the maximum
narrow site (VAnarrow and LAnarrow) and the reference site (VAreference and LAreference) as well as the plaque distribution (ventral, dorsal,
superior, and inferior). Two independent readers reviewed all the images and one reader reevaluated these images 4 weeks
later. The inter- and intra-observer reproducibility was evaluated using the intraclass correlation coefficient (ICC). Results The
measurements of VAnarrow, VAreference, and LAreference using HR MRI showed excellent inter- (ICC=0.801, 0.843, and 0.808,
respectively) and intra-observer reproducibility (ICC=0.811, 0.916, and 0.958, respectively), but the measurement of LAnarrow had
only moderate inter- and intra-observer reproducibility (ICC=0.584 and 0.625, respectively). For plaque distribution analysis
(ventral, dorsal, superior, and inferior plaques), HR MRI also showed excellent inter- (ICC=0.856, 0.836, 0.791, and 0.905,
respectively) and intra-observer reproducibility (ICC=0.876, 0.827, 0.825, and 0.950, respectively). Conclusion HR MRI shows
good inter- and intra-observer reproducibility in identifying MCA-M1 atherosclerotic plaque distribution and vessel and
lumen measurements, but its reliability for lumen area measurement at the maximum narrowing site needs to be improved.