目的 探讨3.0T高分辨率磁共振 成像(HR MRI)对中青年大脑中动脉狭窄性 病变的诊断价值。方法 选择2013年1月 至2017年12月于我院就诊的88例大脑中动 脉狭窄性病变中青年患者，均进行数字减 影血管造影(DSA)和3.0T HR MRI检查，分 析3.0T HR MRI对中青年大脑中动脉狭窄 性病变的诊断价值。结果 共分析88例患 者162支大脑中动脉，与DSA结果相比， 3.0T HR MRI对中青年大脑中动脉轻度狭 窄诊断轻度狭窄、中度狭窄、重度狭窄和 闭塞诊断灵敏度为分别90.70%、90.30%、 84.62%、100%，特异度分别为97.48%、 93.64%、98.53%、99.34%，准确度分别为 95.68%、92.59%、96.30%、99.38%，诊 断一致性分别为0.888、0.832、0.858、 0.949。3.0T HR MRI检查显示162支大脑 中动脉存在稳定斑块者87支，存在不稳定 斑块者75支，其中稳定性斑块纤维帽多完 整，无脂质核心和斑块内出血；部分不稳 定斑块可见脂质核心和斑块内出血。结论 3.0T HR MRI对中青年大脑中动脉狭窄程 度诊断信效度高，与DSA结果一致性好， 可清晰显示大脑中动脉斑块、评估斑块稳 定程度，对中青年大脑中动脉狭窄性病变 诊断具有积极价值。

Objective To investigate the value of 3.0T high-resolution magnetic resonance imaging (HR MRI) in the diagnosis of middle cerebral artery stenosis in young and middle-aged patients. Methods Eighty-eight young and middle-aged patients with middle cerebral artery stenosis who were admitted to the hospital from January 2013 to December 2017 were enrolled in the study. Digital subtraction angiography (DSA) and 3.0T HR MRI were performed and the value of 3.0T HR MRI in the diagnosis of middle cerebral artery stenosis in young and middle-aged patients was analyzed. Results A total of 162 middle cerebral arteries were examined in 88 patients. Compared with results of DSA, the sensitivities of 3.0T HR MRI in the diagnosis of mild stenosis, moderate stenosis, severe stenosis and occlusion in young and middle-aged patients with middle cerebral artery stenosis were 90.70%, 90.30%, 84.62% and 100%, respectively. The specificities were 97.48%, 93.64%, 98.53% and 99.34%, respectively. The accuracy rates were 95.68%, 92.59%, 96.30% and 99.38%, respectively, and the diagnostic consistency was 0.888, 0.832, 0.858 and 0.949, respectively. 3.0T HR MRI showed that there were 87 stable plaques and 75 unstable plaques in 162 middle cerebral arteries. The fiber cap the stable plaque was intact, without lipid core or bleeding in plaques. Some unstable plaques showed lipid core and bleeding in plaques. Conclusion 3.0T HR MRI is of high reliability and validity in the diagnosis of young and middle-aged patients with middle cerebral artery stenosis, with good consistency with results of DSA. It can clearly show the middle cerebral artery plaques and is of positive value for the diagnosis of cerebral artery stenosis in young and middle-aged patients.