3.0T磁共振CE-MRA在腹部至下肢动脉疾病中的应用价值  

Diagnostic Value of Three Dimensional Dynamic Contrast-Enhanced MRA in Arterial Lesions of Abdomen and Lower Extremities with 3.0T MR

作　　者：孟祥水[1] 侯金文[1] 曾庆师[1] 李传福[1] 冯德朝[1] 丛培新[1] 郑金勇[1] 康笑水[1] 

机构地区：[1]山东大学齐鲁医院影像中心,山东济南250012

出　　处：《实用放射学杂志》2007年第5期633-638,共6页Journal of Practical Radiology

摘　　要：目的探讨3.0T超强磁场磁共振三维增强MRA（3D CE-MRA）对腹部、盆腔、下肢血管病变的诊断价值。方法使用GE EXCITEⅡ3.0T双梯度超导磁共振,对61例拟诊腹部至下肢血管病变的受检者行3D CE-MRA检查,其中36例行DSA检查。将腹部至下肢血管分为腹主动脉、髂总动脉、髂外动脉、髂内动脉、股浅动脉、股深动脉、腘动脉、胫前动脉、胫后动脉、腓动脉10个部分,由2位影像学专家独立对3D CE-MRA和DSA资料作出分析。结果61例受检者腹部至下肢血管3D CE-MRA成像均获得满意效果,血管显示清晰。8.2%（5/61）受检者未见异常,91.8%（56/61）受检者显示共计601段血管病变,其中动脉粥样斑块43.4%（261/601）,动脉狭窄22.0%（132/601）,动脉闭塞29.5%（177/601）;动脉迂曲2.7%（16/601）;动脉瘤1.5%（9/601）;动脉夹层0.5%（3/601）;肿瘤压迫或包绕血管0.5%（3/601）。36例3D CE-MRA与DSA比较,3D CE-MRA显示髂总动脉、髂外动脉、股浅动脉、腘动脉、腓动脉血管病变阳性检出率无差异（P〉0.05）,动脉粥样斑块、动脉狭窄及动脉闭塞3种血管病变显示无差异（P〉0.05）。3D CE-MRA显示腹主动脉粥样斑块病变多于DSA（χ^2=5.94,P=0.01）,髂内动脉、股深动脉、胫前动脉、胫后动脉病变阳性检出率高于DSA（P〈0.05）,以DSA为标准,3D CE-MRA存在高估。结论3D CE-MRA是一种有效的评价腹部至下肢动脉疾病的方法,其诊断价值可与DSA相媲美,尤其对直径较大的腹主动脉至腘动脉主干（1-3级血管）可基本代替DSA。Objective To explore the diagnostic value of the three dimensional contrast - enhanced MRA （ 3D CE - MRA ） in demonstrating artery from abdomen to lower extremity with 3.0T MR. Methods 3D CE - MRA was performed in 61 cases with suspected diseases of artery from abdomen to lower extremity on GE EXCITE Ⅱ 3.0T MR,of them, DSA was performed in 36 cases. The arteries were divided into ten groups ： abdominal aorta, common iliac artery, external iliac artery, internal iliac artery, deep femoral artery, superficial femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery and peroneal artery. 3D CE -MRA and DSA findings were independently evaluated by two experienced radiologists. Results On 3D CE - MRA, all arteries in 61 cases were demonstrated clearly, normal arteries were showed in 8.2% （5/61） cases. 601 segments of abnormal arteries were showed in 91.8% （56/61） cases including plaques of atherosclerosis 43.4% （ 261/601 ） , stenoses 22.0% （ 132/601 ） , occlusions 29.5% （ 177/601 ） , tortuous 2.7% （ 16/601 ） , aneurysms 1.5% （9/601） , dissections 0.5% （ 3/601 ） , extra - arterial compressions 0.5% （ 3/601 ）. In 36 cases, there were no statistical difference between 3D CE - MRA and DSA in evaluating common iliac artery, external iliac artery, superficial femoral artery, popliteal artery and peroneal artery （P 〉0.05 ） , and in detecting plaques of atherosclerosis, stenoses and occlusions （ P 〉 0.05 ）. 3D CE - MRA estimated more plaques of atherosclerosis than DSA in 36 cases of abdominal aorta（Х^2 = 5.9406 ,P = 0. 0148 ） ,and more vascular diseases in 36 cases of internal iliac artery, deep femoral artery, anterior tibial artery and posterior tibial artery than DSA （ P 〈 0.05 ）. Conclusion 3 D CE - MRA is an efficient method for evaluating artery diseases in the region from abdomen to lower extremity and it has the comparable efficacy to DSA from abdominal aorta to popliteal artery.

关 键 词：磁共振成像 血管造影术 血管 腹部 下肢 

分 类 号：R445.2[医药卫生—影像医学与核医学] R572[医药卫生—诊断学]