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临床研究｜｜Clinical Articles 磁共振成像 2024年7月第15卷第7期 Chin J Magn Reson Imaging, Jul, 2024, Vol. 15, No. 7

基于多序列磁共振血管壁成像的下肢动脉病变

诊断研究

王丽 ，贺雪平 ，邓炜 ，叶裕丰 1, 2*
1
1
1, 2
作者单位 1.广州医科大学附属番禺中心医院放射科，广州 511400；2.广州市番禺区医学影像研究所，广州 511400
* 通信作者 叶裕丰，E-mail: yeyufengpy@qq.com
中图分类号 R445.2；R654.4 文献标识码 A DOI 10.12015/issn.1674-8034.2024.07.022
本文引用格式 王丽, 贺雪平, 邓炜, 等 . 基于多序列磁共振血管壁成像的下肢动脉病变诊断研究[J]. 磁共振成像, 2024, 15(7):
130-136.
[摘要] 目的 本研究旨在探讨基于延迟进动定制激发（delay alternating with nutation for tailored excitation, DANTE）和可变翻
转角快速自旋回波（sampling perfection with application-optimized contrasts by using different flip angle evolutions, SPACE）的多序
列磁共振血管壁成像 （magnetic resonance vessel wall imaging, MR-VWI） 对下肢动脉病变 （lower extremity arterial disease,
LEAD）的诊断价值。材料与方法 回顾性分析了 57例 LEAD患者和 26例无 LEAD患者的病例及影像资料。所有患者均在 3.0 T
MRI 设备上接受了 T2 快速自旋回波序列（turbo spin echo, TSE）、T1w DANTE-SPACE、对比增强（contrast enhancement, CE）
T1w DANTE-SPACE和 CE磁共振血管造影（magnetic resonance angiography, MRA）MR-VWI扫描。两名放射科医师在双盲条件
下分别测量了 T1w DANTE-SPACE 和 T2w TSE 序列图像相应位置的管腔面积（lumen area, LA）、管壁面积（vessel wall area,
VWA）、平均管壁厚度（average vessel wall, AVW）和最大管壁厚度（maximum vessel wall, MVW）等形态学指标。每位医师在
3周间隔后对相同指标进行了重复测量。采用组内相关系数（intra-class correlation coefficients, ICC）和 Bland-Altman方法评估了
两种扫描技术以及不同组别之间的 T1w DANTE-SPACE 形态学测量指标的观察者一致性和可重复性。使用受试者工作特征
（receiver operating characteristic, ROC） 曲 线 评 估 了 准 确 性 。 结 果 T1w DANTE-SPACE 与 T2w TSE 成 像 技 术 的 信 噪 比
（signal-to-noise ratio, SNR）和对比度比（contrast-to-noise ratio, CNR）差异有统计学意义（P<0.05），两名观察者对形态学测量
指 标 的 ICC 值 在 0.85~0.99 之 间 。 在 不 同 组 别 中 ， T1w DANTE-SPACE 形 态 学 测 量 指 标 的 两 次 测 量 ICC 值 为 0.90~0.99。
Bland-Altman 分析显示，观察者间和两次测量间的大部分形态学测量指标均在 95% 的一致性限度内。T1w DANTE-SPACE 技术
在 LEAD 组不同血管节段的形态学指标 ROC 曲线下面积（area under the curve, AUC）分别为 0.904 [95% 置信区间（confidence
interval, CI）：0.825~0.983]和 0.905（95% CI：0.835~0.976）。当腘小腿动脉段的血管壁厚度为 1.00 mm，LA 为 10.88 mm 时，
LEAD 的敏感度分别为 79.2% 和 85.4%，特异度分别为 96.2% 和 92.3%，阳性预测值分别为 97.4% 和 95.3%，阴性预测值分别为
71.4%和77.4%。结论 多序列MR-VWI在评估LEAD斑块形态学指标方面表现出良好的重复性和高准确性，支持其在LEAD的
MRI检查中的应用。
[关键词] 下肢动脉病变；磁共振成像；血管壁成像；诊断
Diagnosis of lower extremity arterial disease based on multi-sequence magnetic resonance vessel
wall imaging

1, 2
1
WANG Li , HE Xueping , DENG Wei , YE Yufeng 1, 2*
1
1 Department of Radiology, The Affiliated Panyu Central Hospital of Guangzhou Medical University, Guangzhou 511400, China;
2 Medical Imaging Institute of Panyu District, Guangzhou 511400, China.
* Correspondence to YE Y F, E-mail: yeyufengpy@qq.com
Received 5 Jan 2024, Accepted 9 Jul 2024; DOI 10.12015/issn.1674-8034.2024.07.022
ACKNOWLEDGMENTS The Basic and Applied Basic Research Project of Guangzhou Science and Technology Plan (No. 202102080566,
202201011638); Guangzhou Panyu District Science and Technology Plan Project (No. 2022-Z04-006).
Cite this article as WANG L, HE X P, DENG W, et al. Diagnosis of lower extremity arterial disease based on multi-sequence magnetic
resonance vessel wall imaging[J]. Chin J Magn Reson Imaging, 2024, 15(7): 130-136.
Abstract Objective: To investigate the clinical utility of delay alternating with nutation for tailored excitation (DANTE) and sampling
perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) in multi-sequence magnetic resonance
vessel wall imaging (MR-VWI) for diagnosing lower extremity arterial disease (LEAD). Materials and Methods: The case and imaging
data from 57 LEAD patients and 26 without LEAD patients were retrospectively included. All patients underwent T2-weighted turbo spin
echo (T2w-TSE), T1-weighted DANTE-SPACE, contrast-enhanced T1-weighted DANTE-SPACE, and contrast-enhanced magnetic
resonance angiography (CE-MRA) MR-VWI scans on 3.0 T MRI equipment. Lumen area (LA), vessel wall area (VWA), and average
vessel wall thickness (AVW) were measured by two radiologists in a double-blind procedure. The intra-class correlation coefficient (ICC)
and Bland-Altman method were used to assess inter-observer agreement and agreement between different scanning techniques. Receiver
operating characteristic (ROC) curves were used to evaluate accuracy. Results: Signal-to-noise ratio (SNR) and contrast-to-noise ratio
(CNR) values were significantly different between T1w DANTE-SPACE and 2D TSE imaging techniques (P<0.05). ICC values for
morphological measurements ranged from 0.85 to 0.99 between two observers and from 0.90 to 0.99 for repeated measurements.
Bland-Altman analysis showed good agreement between observers and measurements. The T1w DANTE-SPACE technique was applied

收稿日期 2024-01-05 接受日期 2024-07-09
基金项目 广州市科技计划基础与应用基础研究项目（编号：202102080566、202201011638）；广州市番禺区科技计划项目（编号：
2022-Z04-006）

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