A Comparative Study Of High Resolution Magnetic Resonance Imaging,Vascular Ultrasound And Angiography In Cranial And Cervical Artery

Objective: To explore the application value of high resolution magnetic resonance(HRMRI),cranial carotid artery ultrasound(CVUS)and angiography(DSA)in the diagnosis of cranial artery interlayer(CADs).Method: 100 cases with prospective in 2016 in October 2016 to the present in the first hospital affiliated to suzhou university between clinical examination of patients with head and neck artery dissection HRMRI and/or CVUS patients with interlining,52 cases,22 cases with line of digital subtraction angiography(DSA).The clinical manifestations of these patients,the detection rate of HRMRI,CVUS and DSA,the expression types and imaging signs of HRMRI,CVUS and DSA were analyzed,and statistical analysis was performed.Results: All 52 patients underwent HRMRI examination,and 67 arterial vascular interlayer were diagnosed.Among them,there were 18 double lumens,6 endometrium,39 hematoma and 4 dissected aneurysms.Among them,9 visible local tube wall reinforcement.47 patients CVUS examination,a total of 35 bronchitis artery dissection,CVUS on interlining is divided into four types,double cavity)eight,floating valve type 3,intramural hematoma expansion type to 23,tumor sample 1.A total of 22 patients underwent DSA examination and 20 arterial vascular intersections were diagnosed.Among them,there were 3 branches,4 interlayer aneurysms,and 13 indirect signs.Among the 52 patients in this group,22 cases,24 vessels underwent carotid artery stenting(4 cases)or follow-up(18 cases)confirmed the arterial interlayer.In 10 cases,HRMRI,CVUS and DSA were performed simultaneously,and the number of positive blood vessels detected by the three tests was 10,6 and 7.Both HRMRI and CVUS were performed in 22 cases,and24 and 20 positive blood vessels were detected in both tests.HRMRI and DSA diagnostic CADs consistency was 92%,Kappa=0.75,P=0.001.CVUS and DSA diagnostic CADs consistency was 94%,Kappa=0.766,P=0.001.HRMRI and CVUS diagnostic CADs consistency was 91.8%,Kappa=0.749,P=0.001.Conclusion: HRMRI of cranial cervical artery dissection diagnostic sensitivity and accuracy is higher than the DSA and ultrasound examination,can to evaluate lesions and surrounding lumen of the tube wall,is not affected by the lesion location and depth,enhance HRMRI can better and more early evaluation,found that artery dissection pathological changes,is an important examination of cranial cervical artery dissection method.DSA is the gold standard for the determination of lumen stenosis,but it is difficult to make accurate etiological diagnosis for the vascular stenosis caused by thrombus or intramural hematoma.Because of its high sensitivity and convenient operation,CVUS is the main screening method for the vascular interlayer of the neck,but it has limitations in the diagnosis of intracranial vascular interlayer.