锁骨下动脉盗血综合征的MRA诊断  

MRA in the diagnosis of subclavian steal syndrome

作　　者：陈福刚[1] 沙琳[1] 边杰[1] 程绍玲[1] 黄东[1] 董敬东[1] 

机构地区：[1]大连医科大学附属第二医院放射科,辽宁大连116027

出　　处：《大连医科大学学报》2010年第1期67-70,共4页Journal of Dalian Medical University

摘　　要：[目的]通过PC-MRA、TOF-MRA和CE-MRA对锁骨下动脉盗血综合征诊断的比较分析,探讨综合运用不同方法磁共振血管成像(Magnetic resonance angiography,MRA)技术对锁骨下动脉盗血综合征进行诊断。[方法]回顾性分析经DSA检查证实锁骨下动脉盗血综合征患者12例、12处狭窄(右侧4例,左侧8例),所有患者均行PC-MRA、TOF-MRA、CE-MRA和DSA检查。对三种MRA方法对锁骨下动脉盗血综合征的诊断进行比较分析。[结果]锁骨下动脉窃血12例患者中,共12处狭窄(无名动脉4处,左侧锁骨下动脉起始部8处)。TOF-MRA对狭窄均未做出定性诊断,未能对窃血做出定性诊断与定量分析;CE-MRA对12处狭窄的定性诊断准确,对狭窄程度判断7例准确,对狭窄长度的诊断10例准确,对8例窃血定性诊断准确,不能对窃血进行定量分析;PC-MRA对所有12例窃血定性诊断准确,并做出定量分析。[结论]PC-MRA可以对锁骨下动脉窃血进行定性诊断和定量分析;CE-MRA能够对锁骨下动脉狭窄进行定性和定量诊断,可对部分锁骨下动脉窃血进行定性诊断但不能做定量分析,TOF-MRA对锁骨下动脉狭窄诊断能力有限;综合运用PC-MRA和CE-MRA可以对锁骨下动脉狭窄做出全面准确评价。[ Objective ] To detect various kinds of Magnetic Resonance Angiography （MRA） techniques in the diagnosis of subclavian steal syndrome,by comparing PC - MRA,TOF - MRA and CE - MRA. [ Methods] Twelve patients with subclavian steal syndrome and twelve stenosis sites （4 on the right and 8 on the left） demonstrated by DSA. PC - MRA,TOF - MRA, CE -MRA and DSA were retrospectively analyzed. The three MRA techniques also compared. [ Results] There were 12 stenosises in the 12 patients （4 in innominate artery and 8 in proximal left subclavian artery）. TOF - MRA couldnt provide not only qualitative diagnosis on stenosis, but also qualitative and quantitative diagnosis on blood steal. CE - MRA gave correct qualitative diagnosis on 12 stenosis, accurately assessed the stenosis degree in 7 patients and the stenosis longitude in 10 patients. It also qualitatively diagnosed 8 cases of blood steal but failed for quantitative analysis. PC - MRA correctly diagnosed blood steal in all of 12 cases, both qualitative and quantitative. [ Conclusion ] PC - MRA could provide both qualitative and quantitative diagnosis to subclavian steal syndrome ; CE - MRA could provide qualitative and quantitative diagnosis to subclavian stenosis and partial qualitative diagnosis to subclavian steal syndrome but not quantitative diagnosis of it ; TOF - MRA is limited in subclavian stenosis. Accurate diagnosis to subclavian stenosis could be done by PC - MRA combined with CE -MRA.

关 键 词：磁共振血管造影术 颈动脉狭窄 盗血综合征 

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