彩色多普勒血流图与磁共振血管造影诊断肾动脉病变的应用研究  

Application of renal artery stenosis diagnosis using CDFI and MR angiography

作　　者：范锐斌[1] 方先来[1] 马绍椿[2] 孟志华[1] 肖雨雄[1] 李少明[1] 胡秀莲[2] 陈红[3] 陈海杰[1] 

机构地区：[1]粤北人民医院影像诊断科,广东韶关512026 [2]粤北人民医院心血管内科,广东韶关512026 [3]粤北人民医院信息科,广东韶关512026

出　　处：《中国现代医学杂志》2007年第5期575-579,582,共6页China Journal of Modern Medicine

基　　金：2005年韶关市医药卫生科研计划项目(No.Y04104)

摘　　要：目的评价彩色多普勒血流图(CDFI)与增强磁共振血管造影(CEMRA)诊断肾动脉狭窄(RAS)的价值。方法84例患者行CDFI初步筛查确定肾动脉及其3、4级分支情况;55例行MRA检查明确肾动脉病变,38例行DSA检查。应用TESTBOLUS先以2mL/s试注射测定肾动脉最佳显示时间,再从前臂静脉注射造影剂Magnevist 20 mL,延时20～35s行双肾动脉容积数据扫描;层厚1.1mm,连续共4次;源像输入RON-ADO2004A工作站作三维重建。结果发现左、右RAS各为18、30例,轻、中、重度狭窄各26、15、7例;5例行RAS扩张成形介入治疗。CDFI、MRA与DSA对照诊断轻度RAS的敏感性、特异性和准确性各为95%、100%,100%、100%,96%、100%;诊断中、重度RAS的敏感性,特异性和准确性各为92%、100%,100%、50%,93%、93%。结论CDFI筛查及CEMRA诊断RAS均有重要作用,能提供RAS的全面信息;对RAS所致高血压的诊治有重要意义。[Objective] To evaluate the clinical value using color dopple flow image （CDFI） and contrast enhancement MR angiography （CEMRA） and digital subtraction angiography （DSA） for diagnosing renal artery stenosis （RAS）. [Methods] 84 cases were elementarily examined using CDFI. 55 cases were examined using CEMRA. 38 cases were examined using DSA. A volume of 2 mL Magnevist was injected at rate 2 mL/s with a scan delay of 20-35 s. Scan data was acquired using 1.1 mm. 4 times of scan were carried out. The source images were transferred to an independent work station RONADO2004A for three-dimensional reconstruction. Their fourth grade branch of renal artery were analyzed. [Results] Left and right RAS were 18 and 30 cases. The stenotic cases were slight 26, moderate 15 and severe 7 respectively. The sensitivity, specificity and accuracy of CDFI group and CEMRA can contrast to DSA were 95%, 100%, 100%, 100%, 96%, 100% （slight group） and 92%, 100%, 100%, 50%, 93%, 93% （moderate-severe group） respectively. [Conclusion] CDFI playing a role in primary examining RAS, CEMRA can take an important role. Taking correct and immediate examination, various image data can be helpful for diagnoses and treatment of hypertension due to RAS.

关 键 词：多普勒超声 MR血管造影 体层摄影术 三维重建 肾动脉狭窄 

分 类 号：R445.1[医药卫生—影像医学与核医学]