中国卒中杂志 ›› 2022, Vol. 17 ›› Issue (09): 950-956.DOI: 10.3969/j.issn.1673-5765.2022.09.007

• 论著 • 上一篇    下一篇

磁敏感加权成像相位图病灶周围极晕鉴别单纯出血或钙化的价值研究

苏录，高培毅   

  1. 1 北京 100070 首都医科大学附属北京天坛医院放射科 
    2 北京市神经外科研究所神经影像中心
  • 收稿日期:2022-04-20 出版日期:2022-09-20 发布日期:2022-09-20
  • 通讯作者: 高培毅 cjr.gaopeiyi@vip.163. com

The Application Value of Indirect Method of Peri-lesion Polar-halo Sign on SWI Phase Image in Differentiating Simple Calcification from Hemorrhage: A Retrospective Study

  • Received:2022-04-20 Online:2022-09-20 Published:2022-09-20

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摘要： 目的 比较SWI相位图病灶本身信号强度（传统直观）法与病灶周围征象即极晕（间接）法对单纯出血或单纯钙化的诊断效能。
方法 本研究纳入以随访CT为“金标准”（单次病灶CT或复查CT值变化）的单纯钙化灶和单纯出血灶。针对每个病灶分别采用SWI相位图病灶本身信号强度（传统直观）法和病灶周围极晕（间接）法评估。SWI相位图全部转换为右手图后再进行评估。SWI相位图病灶本身信号强度（传统直观）法评估标准：病灶本身呈低、高信号分别代表出血及钙化。病灶周围极晕（间接）法评估标准：低信号两极征或高信号反晕征，认定病变为出血；高信号两极征或低信号反晕征，认定病变为钙化。用科恩Kappa值评估两名观察者评判相位图病灶本身信号强度、病灶周围极晕结果的一致性。采用阴性预测值、阳性预测值、敏感度及特异度评估上述两种方法鉴别钙化的诊断效能。
结果 共纳入224个病灶（共36例患者）。其中出血灶123个病灶（8例患者），钙化灶101个病灶（28例患者）。两名观察者病灶本身信号强度法（K=0.768）及病灶周围极晕法（K=0.876）分析SWI相位图的结果一致性较好。SWI相位图病灶本身信号强度法鉴别钙化的阳性预测值、阴性预测值、敏感度及特异度分别为66.7%、70.2%、61.4%、74.8%。病灶周围极晕法鉴别钙化的阳性预测值、阴性预测值、敏感度及特异度分别为99.0%、97.6%、97.0%、99.2%。
结论 SWI相位图病灶周围极晕法具有潜在的临床实用价值，有可能成为一种简便易行的MR鉴别单纯出血或钙化的方法。

文章导读： SWI相位图病灶周围极晕（两极征和反晕征）法可能是一种简便易行的MR鉴别单纯出血或单纯钙化的方法。

关键词: 磁敏感加权成像; 相位; 出血; 钙化; 极晕法

Abstract: Objective  To compare the diagnostic value of traditional method of signal intensity of foci and indirect signs (reversed halo sign and bipolar sign) on SWI phase image in differentiating simple calcification from hemorrhage.
Methods  The included simple calcification and simple hemorrhage were confirmed by follow-up CT scan. All the lesions were evaluated by traditional method and indirect polar-halo method. The evaluation standard of traditional method as follows: low and high intensity sign representing hemorrhage and calcification, respectively. The evaluation standard of indirect method as follows: low signal intensity bipolar sign or high signal intensity reversed halo sign representing hemorrhage, and high signal intensity bipolar sign or low signal intensity reversed halo sign representing calcification. The Kappa value was calculated to evaluate the consistency of lesion signal intensity and peri-lesion polar-halo sign results between the two observers. Positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity were calculated to evaluate the diagnosis value of SWI direct and indirect characteristics in differentiating simple calcification and hemorrhage.
Results  A total of 224 lesions (36 patients) were included, with 101 simple calcifications (28 patients) and 123 simple hemorrhagic lesions (8 cases). The consistency coefficient of the two observers on traditional method and indirect polar-halo method was 0.768 and 0.876, respectively. The PPV, NPV, sensitivity and specificity of traditional method in identifying calcification were 66.7%, 70.2%, 61.4% and 74.8%, respectively. The PPV, NPV, sensitivity and specificity of polar-halo method in identifying calcification were 99.0%, 97.6%, 97.0% and 99.2%, respectively.
Conclusions  The indirect polar-halo sign on SWI phase image has a higher diagnostic accuracy, which may be a more reliable way to differentiate simple hemorrhage from simple calcification.

Key words: Susceptibility weighted imaging; Phase; Hemorrhage; Calcification; Polar-halo method

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