A Study Of MRA And DSA In Diagnosis Of MCA M1Segment Stenosis

Objective DSA as the gold standard, comparative analysis1.5T TOF-MRA inmiddle cerebral artery M1segment stenosis were taken from142patients withischemic cerebral vascular disease in line to investigate the clinical value ofmagnetic resonance angiography in the diagnosis of ischemic cerebrovasculardisease.Methods During October2011to October2012,142patients with ischemiccerebrovascular disease, according to the2010guidelines of diagnosis and treatmentof acute ischemic cerebrovascular disease, were chosen from department ofneurology and all cases were undergone MRA and DSA examination in a week.With DSA as a standard, specificity, sensitivity, accuracy, and negative predictivevalue of MRA in the diagnosis of middle cerebral artery M1segment stenosis werecalculated, comparative analysis1.5T TOF-MRA diagnosis of compliance of themiddle cerebral artery stenosis with DSA, analysis stenosis degree high or low ofMRA in the diagnosis of the initial segment, middle and distal of middle cerebralartery M1segment, and then evaluate the clinical value of MRA in the diagnosis ofM1segment stenosis.Result284middle cerebral artery M1segment in142patients were examinedby DSA and MRA, in which248results by MRA were consist with that by DSA.The overall accuracy of MRA were about87%. Sensitivity, specificity, Youden’sindex, positive predictive value, and negative predictive value of MRA in thediagnosis of moderate Middle cerebral artery stenosis were50%,98.3%,0.48,16.7%,99.1%respectively; for severe middle cerebral artery stenosis, the sensitivity,specificity, accuracy, Youden’s index, positive predictive value and negativepredictive value were50%,98.3%,0.48,50%and98.3%respectively; Sensitivity tomiddle cerebral artery occlusion is about93.8%. MRA in the diagnosis of middlecerebral artery M1segment (initial segment, middle and distal) stenosis degree，x2 =16.799，p＜0.005；rs＝－0.330，p＝－0.003.Conclusion The accuracy of MRA in the diagnosis of the initial segment,middle, distal of cerebral artery M1segment is difference, the distal for threestenosis prone to excessive diagnosis; The value of MRA exclude the diagnosis ofmiddle cerebral artery M1segment stenosis is high easily; The value of MRAdiagnosis moderate stenosis in middle cerebral artery is low, therefore, MRA showedmoderate stenosis is necessary to further DSA.