MRI多序列与动态增强扫描对动脉易损斑块的评估  

MRI with multiple contrast weightings and dynamic contrast enhancement in evaluation of vulnerable atherosclerotic plaques

作　　者：赵炳辉[1] 李明华[1] 赵清[2] 赵俊功[1] 肖云峰[1] 

机构地区：[1]上海交通大学第六人民医院放射科,上海200233 [2]上海交通大学第六人民医院心内科,上海200233

出　　处：《上海交通大学学报（医学版）》2008年第1期9-12,28,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科委基金(05JC14031)~~

摘　　要：目曲探讨高强场磁共振（MRI）多序列与动态增强扫描对动脉易损斑块的评估价值。方法支选取40只雄性新西兰大白兔给予高脂饮食，2周后行右侧髂总动脉和髂外动脉拉伤，继续高脂饮食6—20周之后，分别行MRI多序列与多期动态增强扫描。MRI增强前后采用T1W抑脂序列，分别于增强前、注射对比剂Gd-DTPA后1、5、15和25min进行扫描，并对病理与MRI影像结果进行分析。结幂80个位于右侧髂总动脉和髂外动脉粥样硬化斑块中，易损斑块34个（42．5％），稳定斑块46个（57．5％）。MRI多序列扫描对动脉斑块易损性的评估准确度为73．8％，对易损斑块的诊断敏感度和特异度分别为82．3％和67．4％。易损斑块与稳定斑块的MRI强化方式不同，MRI多序列与动态增强检查相结合对易损斑块的诊断准确度、敏感度和特异度分别为87．5％、94．1％和82．6％，均明显高于MRI多序列扫描（P〈0．05）。结论MRI动态增强扫描对易损斑块的检出和定性具有重要价值，不同的强化方式有助于动脉斑块易损性的判断。Objective To analyze the utility of MRI with multiple contrast and dynamic contrast weightings enhancement （DCE） in evaluation of vulnerable atherosclerotic plaques. Methods Forty male New Zealand white rabbits were fed with hypereholesterolemie diet, and right iliae arteries including the common and external iliae arteries were examined by multiple contrast and DCE MRI at intervals 6 to 20 weeks after balloon denudation. For multiple contrast weightings scanning, T1-, T1-/T2WI with fat suppression, proton density weighted and double invention recovery were used. Meanwhile, post DCE T1- with fat suppression images were obtained in 1,5,15 and 25 min after a bolus injection of Gd-DTPA contrast agent. Then a comparative analysis of plaque morphology and components to images was performed. Results There were 34 （42.5%） vulnerable plaques and 46 （57.5%） stable plaques amomg the 80 atheroselerotie lesions located at the right common or external iliae arteries. The accuracy, sensitivity and specificity of MRI with multiple contrast weightings and DCE for the detection of vulnerable plaques were 87.5% , 94.1% and 82.6% , respectively, significantly higher than those only with multiple contrast weightings, which were 73.8% ,82.3% and 67.4% , respectively （P 〈 0.05）. And different characteristics were observed between vulnerable and stable plaques after a bolus agent injection from MRI. Conclusion MRI with dynamic contrast enhancement may play an important role in detection and differentiation of vulnerable atheroselerotie plaques according to different characteristics of contrast enhancement.

关 键 词：动脉易损斑块 磁共振成像 动态增强 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.5[医药卫生—诊断学]