MIDDLE CEREBRAL-ARTERY STENOSES - ASSESSMENT BY MAGNETIC-RESONANCE ANGIOGRAPHY AND TRANSCRANIAL DOPPLER ULTRASOUND
MIDDLE CEREBRAL-ARTERY STENOSES - ASSESSMENT BY MAGNETIC-RESONANCE ANGIOGRAPHY AND TRANSCRANIAL DOPPLER ULTRASOUND
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DOI：
10.1159/000108494
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发表时间：
1994-07-01
影响因子：
2.9
通讯作者：
HENNERICI, M
中科院分区：
文献类型：
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作者：
ROTHER, J;SCHWARTZ, A;HENNERICI, M
将单侧或双侧大脑中动脉(MCA)狭窄的磁共振血管成像(MRA)结果与经颅多普勒超声(TCD)和数字减影血管成像(DSA)结果进行比较。18例患者共22条大脑中动脉狭窄按TCD标准入选。为了评价MRA、TCD和DSA的诊断准确性，建立了狭窄的分类标准。MRA证实TCD显示大脑中动脉狭窄21条(n=22)。TCD(I级)和MRA诊断的6例DSA均未显示大脑中动脉狭窄。MRA对大脑中动脉狭窄的分类与TCD相关的有11例(50%)，而MRA低估狭窄的3例(14%)，高估的8例(36%)。与TCD和DSA相比，MRA检出大脑中动脉狭窄的敏感性很高(100%)，但三种技术对狭窄程度的相关性较差。这种不一致的部分原因是常规DSA不足以可靠地估计狭窄程度，因为它只提供一个前后投影平面。MRA和TCD联合应用是一种敏感性高的无创性检查方法，可确保MCA狭窄的诊断和判断梗阻的严重程度。
Magnetic resonance angiography (MRA) findings of uni- or bilateral middle cerebral artery (MCA) stenosis were compared with results of transcranial Doppler ultrasound (TCD) and digital subtraction angiography (DSA). Eighteen patients with 22 MCA stenoses were selected by TCD criteria. To evaluate the diagnostic accuracy of MRA, TCD and DSA, criteria for classification of stenoses were established. MRA confirmed 21 MCA stenoses as revealed by TCD (n = 22). DSA did not demonstrate MCA stenoses in 6 cases diagnosed by TCD (classification grade I) and MRA. The classification of MCA stenoses by MRA correlated with TCD in 11 (50%) cases, while stenosis was underestimated by MRA in 3 (14%) and overestimated in 8 (36%) MCAs. Whereas the sensitivity of MRA for the detection of MCA stenoses compared to TCD and DSA findings was very high (100%), the correlation of the degree of stenosis by the three techniques was poor. This discordance is partly due to the insufficiency of routine DSA to reliably estimate the degree of stenosis since it delivers only one anterior-posterior projection plane. The combination of MRA and TCD is a noninvasive regime of high sensitivity to ensure the diagnosis of MCA stenosis and to estimate the severity of obstruction.