The diagnostic value of high-resolution magnetic resonance black blood technology imaging and CT angiography in detecting carotid plaque in predicting stroke
10.3760/cma.j.cn115455-20250103-00007
- VernacularTitle:高分辨率磁共振黑血成像技术与CT血管成像检测颈动脉斑块对脑卒中的预测价值
- Author:
Xiaofei ZHANG
1
;
Guohua WU
1
;
Qi WANG
1
;
Chao LI
1
Author Information
1. 邯郸市中心医院CT、MR室，邯郸 056004
- Publication Type:Journal Article
- Keywords:
Carotid artery diseases;
High-resolution magnetic resonance black blood technology imaging;
CT Angiography;
Stroke;
Diagnosis
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(11):969-975
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic value of high-resolution magnetic resonance black blood technology imaging (MRBTI) and CT angiography (CTA) in detecting carotid plaque in predicting stroke.Methods:A prospective study was conducted on 135 patients with carotid artery disease diagnosed and treated in Handan Central Hospital from January 2020 to June 2022, all patients underwent cervical MRBTI and CTA examinations. Digital subtraction angiography (DSA) was used as the gold standard to compare the diagnostic value of the two detection methods for carotid plaque properties. Patients were followed up for 2 years and divided into stroke and non-stroke according to the result of follower-up. Imaging indexes of the two groups were compared, and the predictive value of MRBTI combined with CTA for stroke was evaluated by receiver operation characteristic (ROC) curve.Results:The relevant data of 134 patients were included in statistical analysis. For severe carotid stenosis and ulcerative plaques, the accuracy of CTA examination was 85.11% and 84.91% separately, that of MRBTI examination was 91.49% and 92.45%, the combined examination was 95.74% and 96.23%, and the above three examination methods was not statistically significant ( P>0.05). The detection accuracy rates of CTA for mild, moderate carotid artery stenosis and smooth, irregular plaque, were 73.08%, 86.89%, 73.91% and 86.21%, those of MRBTI detection were 92.31%, 91.80%, 86.96% and 93.10%, and those of combined detection were 100.00%, 98.36%, 100.00% and 98.28%, the combined detection was higher than those of CTA and MRBTI alone ( P<0.05); there was no statistically significant difference in the level of tube wall area between the stroke patients and the non-stroke patients ( P>0.05), but the total vascular area and lumen area in stroke patients were significantly higher than those in non-stroke patients: (103.48 ± 22.48) mm 2 vs. (92.51 ± 16.26) mm 2, (46.18 ± 11.03) mm 2 vs. (41.32 ± 10.52) mm 2, and normal wall index was significantly lower: (0.54 ± 0.12) mm 2 vs. (0.61 ± 0.09) mm 2 ( P<0.05); ROC curve analysis showed that MRBTI combined with CTA had the best predictive efficacy for stroke, with area under the curve (AUC) value as high as 0.82, and its sensitivity (79.00%) was significantly higher than that predicted by MRBTI indexes (total vascular area, lumen area and normal wall index) (51.90%, 39.50%, 56.80%) or CTA (30.90%) alone, with statistically significant difference ( P<0.05). Conclusions:The combination of MRBTI and CTA can improve the diagnostic efficiency of carotid artery disease and the prediction efficiency of stroke, and can be used as an auxiliary examination means of DSA to provide a more reliable clinical basis for the assessment of plaque characteristics in patients with carotid artery disease and the prediction of stroke.
