冠状动脉搭桥术后磁共振桥血管成像的初步探讨  

MR imaging of coronary artery bypass graft: a preliminary study

作　　者：张竹花[1,2] 朱杰敏[1,2] 刘玉清[1,2] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院放射科 [2]中国医学科学院中国协和医科大学阜外医院放射科

出　　处：《中华放射学杂志》1999年第7期468-472,共5页Chinese Journal of Radiology

摘　　要：目的以ＭＲ成像评价桥血管开通及功能，探讨适用于国人冠状动脉搭桥（ＣＡＢＧ）术后的影像学随访手段。方法用１５ＴＭＲ机检查２７例ＣＡＢＧ术后患者的７４支桥血管，行屏气快速场回波（ＦＦＥ）序列扫描观察桥血管的开通。其中１６例４２支桥血管行相位对比磁共振血流成像（ＰＳＭＲＡｆｌｏｗ），得出血流速度和流量曲线，对桥血管的开通进行再评价。结果本组桥血管ＦＦＥ成像开通率为８９２％（６６／７４）。以ＰＳＭＲＡｆｌｏｗ评价，２支ＦＦＥ认为开通，而ＰＳＭＲＡｆｌｏｗ示为不确定，其余４０支评价相同。本组３２支桥血管的ＰＳＭＲＡｆｌｏｗ序列血流曲线，２５支呈舒张期灌注型。对照７例患者左侧搭桥与右侧未搭桥乳内动脉的血流曲线，前者收缩期流速峰值（ＳＰＶ）明显低于后者，而舒张期流速峰值（ＤＰＶ）及ＤＰＶ与ＳＰＶ的比值明显高于后者。结论屏气ＦＦＥ和ＰＳＭＲＡｆｌｏｗ成像是判断桥血管开通和获取血流速度、流量曲线的有效方法，作为一种筛选技术可试用于临床，其特异性和敏感性有待进一步研究。Objective To study the patency and function of coronary artery bypass grafts(CABG) by magnetic resonance(MR) imaging and to establish a suitable method for followup study after CABG surgery Methods5BZMR imaging was performed with a Toshiba 15T unit in 27 patients with 74 graftsAll patients were examined with a breathhold ECGgated twodimensional fast field echo (FFE) sequence to evaluate the patency of bypass grafts,and among them 16 patients with 42 grafts were further examined with phase shift magnetic renance angiography flow (PSMRAflow) sequence to evaluate the graft patency as well as flow velocity and flow volume vs time Results 66 of the 74 grafts in patients of the present series studied with FFE were patent with a patency rate of 892%The results evaluated both with FFE and PSMRAflow were consistent except two grafts which were patent with FFE but the results with PSMRAflow were uncertain Diastolic perfusion pattern curves were demonstrated in 25 of the 32 grafts Comparing the flow curves of the grafted left internal mammary artery with those of the native right internal mammary artery in 7 patients, the systolic peak velocity value (SPV) of the grafted arteries was significantly lower than that of the ungrafted ones, whereas the diastolic peak velocity value (DPV) and the ratio of DPV to SPV were significantly greater than those of the ungrafed ones 5HZConclusions The FFE and PSMRAflow sequences are efficient in evaluating the patency of the bypass grafts, and obtaining the curves of flow velocity and volume as well therefore, they may offer a reasonable followup study in patients after CABG surgery, although its accuracy should be further evaluated in more patients and compared with other methods

关 键 词：冠状动脉分流术 磁共振血管造影 

分 类 号：R654.2[医药卫生—外科学] R445.2[医药卫生—临床医学]