[1]林圣美,程章波,张玮,等.T1 SPACE技术诊断Cockett综合征的临床应用价值[J].福建医药杂志,2022,44(04):1-5.
 LIN Shengmei,CHENG Zhangbo,ZHANG wei,et al.Clinical value of T1 SPACE technique in the diagnosis of Cockett syndrome[J].FUJIAN MEDICAL JOURNAL,2022,44(04):1-5.
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T1 SPACE技术诊断Cockett综合征的临床应用价值()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
44
期数:
2022年04期
页码:
1-5
栏目:
临床研究
出版日期:
2022-08-15

文章信息/Info

Title:
Clinical value of T1 SPACE technique in the diagnosis of Cockett syndrome
文章编号:
1002-2600(2022)04-0001-05
作者:
林圣美程章波1张玮殷磊苏家威马明平2
福建医科大学省立临床医学院 福建省立医院放射科(福州 350001)
Author(s):
LIN Shengmei CHENG Zhangbo ZHANG wei YIN lei SU Jiawei MA Mingping
Department of Radiology,Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China
关键词:
Cockett综合征非增强磁共振成像数字减影血管造影
Keywords:
Cockett syndrome non-contrast magnetic resonance imaging digital subtraction angiography
分类号:
R14
文献标志码:
B
摘要:
目的 探讨T1 SPACE技术诊断Cockett综合征的临床应用价值。方法 收集我院患有慢性下肢静脉疾病且临床考虑Cockett综合征的患者96例,在行数字减影血管造影检查前2 d内行非增强磁共振血管检查。在T1 SPACE序列上测量患侧髂总静脉受压狭窄处前后径和健侧髂总静脉远端分叉处前后径,并计算出狭窄率,观察盆腔内侧支血管显影情况。以数字减影血管造影检查结果为金标准,计算最大约登指数下对应的狭窄率,采用ROC曲线评估最大约登指数下单独运用髂总静脉狭窄率及狭窄率联合侧支血管对Cockett综合征的诊断效能。结果 在T1 SPACE图像上髂总静脉平均狭窄率为(47.77±21.16)% 。以狭窄率作为诊断Cockett综合征的标准,ROC曲线下面积为 0.738,取最大约登指数对应狭窄率43.85% 作为诊断截点,敏感性为63.90%,特异性为83.30%,诊断符合率为68.75%; 以髂静脉狭窄率≥43.85%联合侧支血管显像作为诊断标准,ROC曲线下面积为0.867,敏感性为 90.10%,特异性为 83.30%,诊断符合率 87.50%,两者差异有统计学意义(P<0.05)。结论 在T1 SPACE技术检查中,髂静脉受压狭窄率对Cockett综合征有较好的诊断效能,狭窄率联合侧支血管能进一步提高磁共振对Cockett综合征的诊断效能,T1 SPACE技术具有较好的临床应用价值。
Abstract:
Objective To explore the clinical value of T1 SPACE technique in the diagnosis of Cockett syndrome.Methods Clinical data of 96 patients with chronic lower extremity venous disease and clinically suspected Cockett syndrome in our hospital who underwent non-contrast magnetic resonance angiography within 2 days before digital subtraction angiography were collected.The anteroposterior diameter of the compressed stenosis of the ipsilateral common iliac vein and the anteroposterior diameter of the distal bifurcation of the unaffected common iliac vein were measured on T1 SPACE sequence.The stenosis rate was calculated, and the situation of pelvic medial branch vessels was observed.The corresponding stenosis rate under the maximum Youden index was calculated by using the results of digital subtraction angiography as the gold standard.The ROC curve was used to evaluate the diagnostic efficacy of the common iliac vein stenosis rate and stenosis rate combined with collateral vessels on Cockett syndrome.Results The average stenosis rate of the common iliac vein on T1 SPACE images was(47.77±21.16)%.Taking the stenosis rate as the criterion for the diagnosis of Cockett syndrome, the area under the ROC curve was 0.738.The stenosis rate was 43.85% corresponding to the maximum Youden index and it was taken as the diagnostic cut-off point.The sensitivity was 63.90%, the specificity was 83.30%, and the diagnostic coincidence rate was 68.75%.Taking the iliac vein stenosis rate ≥43.85% combined with collateral vessel imaging as the diagnostic criteria, the area under the ROC curve was 0.867, the sensitivity was 90.10%, the specificity was 83.30%, and the diagnostic coincidence rate was 87.50%.The difference between the two methods was statistically significant(P<0.05).Conclusion The iliac vein compression stenosis rate has a good efficiency in the diagnosis of Cockett syndrome, and the stenosis rate combined with collateral vessels can further improve the diagnostic efficiency with T1 SPACE technique, T1 SPACE technique has good clinical value.

参考文献/References:

[1] Zucker E J, Ganguli S, Ghoshhajra B B, et al.Imaging of venous compression syndromes [J].Cardiovasc Diagn Ther, 2016, 6(6): 519-532.
[2] Rohr A, Maxwell K, Best S, et al.Rare presentation and endovascular treatment of multifocal iliac venous stenoses due to right sided May-Thurner syndrome [J].Radiol Case Rep, 2020, 15(3): 201-203.
[3] Wu F, Song H, Ma Q, et al. Hyperintense plaque on intracranial vessel wall magnetic resonance imaging as a predictor of artery-to-artery embolic infarction [J].Stroke, 2018, 49(4): 905-911.
[4] Yang Q, Duan J, Fan Z, et al.Early detection and quantification of cerebral venous thrombosis by magnetic resonance black-blood thrombus imaging [J].Stroke, 2016, 47(2): 404-409.
[5] Raju S, Neglen P.High prevalence of nonthrombotic iliac vein lesions in chronic venous disease: a permissive role in pathogenicity [J].J Vasc Surg, 2006, 44(1): 136-144.
[6] Narayan A, Eng J, Carmi L, et al.Iliac vein compression as risk factor for left- versus right-sided deep venous thrombosis: case-control study [J].Radiology, 2012, 265(3): 949-957.
[7] Carr S, Chan K, Rosenberg J, et al.Correlation of the diameter of the left common iliac vein with the risk of lower-extremity deep venous thrombosis [J].J Vasc Interv Radiol, 2012, 23(11): 1467-1472.
[8] 薛海林, 王利伟, 王绍娟, 等.磁共振静脉造影诊断Cockett综合征的价值 [J].介入放射学杂志, 2017, 26(9): 783-786.
[9] Radaideh Q, Patel N M, Shammas N W.Iliac vein compres-sion: epidemiology, diagnosis and treatment [J].Vascular health and risk management, 2019, 12(15):115-122.
[10] Fan Z, Zhang Z, Chung Y C, et al.Carotid arterial wall MRI at 3T using 3D variable-flip-angle turbo spin-echo(TSE)with flow-sensitive dephasing(FSD)[J].J Magn Reson Imaging, 2010, 31(3): 645-654.
[11] Cheng L, Zhao H, Zhang F X.Iliac vein compression syndrome in an asymptomatic patient population: a prospective study [J].Chin Med J(Engl), 2017, 130(11): 1269-1275.
[12] Massenburg B B, Himel H N, Blue R C, et al.Magnetic resonance imaging in proximal venous outflow obstruction [J].Ann Vasc Surg, 2015, 29(8): 1619-1624.
[13] Ou-Yang L, Lu G M.Underlying anatomy and typing diagnosis of May-Thurner syndrome and clinical significance: an observation based on CT [J].Spine(Phila Pa 1976), 2016, 41(21): 1284-1291.
[14] Harbin M M, Lutsey P L.May-Thurner syndrome: history of understanding and need for defining population prevalence [J].J Thromb Haemost, 2020, 18(3): 534-542.

备注/Memo

备注/Memo:
基金项目:福建省自然科学基金资助项目(2021J01396)
1 心血管外科; 2 通信作者
更新日期/Last Update: 2022-08-15