螺旋CT血管成像及非增强磁共振血管造影时间飞跃法对肾动脉狭窄的影像诊断价值初探  

Imaging diagnosis of renal artery stenosis:comparing CTA with 3D Time-of-Flight MR angiography

作　　者：欧陕兴[1] 张莉[1,2] 彭光明[1] 钱民[1] 李小荣[1,2] 齐燕[1,2] 

机构地区：[1]广州军区总医院放射科,广东510010 [2]广州中医药大学,广东510405

出　　处：《中华高血压杂志》2011年第1期38-42,共5页Chinese Journal of Hypertension

摘　　要：目的探讨螺旋CT血管成像(CTA)与非增强磁共振血管造影时间飞跃法(3D TOF MRA)在诊断肾动脉狭窄方面的临床应用价值。方法搜集临床拟诊为继发性高血压的患者病例资料220份,分别行双源CT肾动脉CTA及3D TOF MRA肾动脉造影检查,将影像检查结果与临床手术或数字减影血管造影(DSA)结果对比,同时分析两者的图像质量,比较两者在诊断肾动脉狭窄方面的优缺点。结果共检出狭窄肾动脉81例,其中CTA诊断敏感度100%、特异度98.5%、阳性预测值93.1%、阴性预测值100%;3D TOF MRA诊断敏感度75.3%、特异度100%、阳性预测值100%、阴性预测值95.2%;DSCT肾动脉CTA对各肾段动脉显影的图像质量明显高于3D TOFMRA肾动脉造影图像质量,3D TOF MRA肾动脉造影对4级及以下肾动脉基本未见显影。结论 DSCT肾动脉CTA和3D TOF MRA肾动脉造影在检查肾动脉狭窄及对肾段动脉显影方面有明显差异,CTA明显优于3D TOFMRA。Objective To evaluate the diagnostic accuracy of CT renal artery angiography（CTA）and 3D Time-of-Flight MR angiography（3D TOF MRA）for the diagonosis of renal artery stenosis.Methods CTA and 3D TOF MRA were performed in 220 patients who were clinically diagnosed as secondary hypertension.The imaging diagnosis was compared with the clinical diagnosis,including the results of DSA.The imaging quality of the two methods were evaluated.Results Eighty-one cases were clinically diagnosed as renal artery stenosis.The diagnosis based on CT showed a sensitivity of 100%,a specificity of 98.5%,a positive predictive value of 93.1% and a negative predictive value of 100%,while the diagnosis based on 3D TOF MRA showed a sensitivity of 75.3%,a specificity of 100%,a positive predictive value of 100% and a negative predictive value of 95.2%.And the imaging quality of CTA was better than that of 3D TOF MRA.The sub-segment renal artery imaging of 3D TOF MRA could not be evaluated,especially those under 4th.Conclusion 3D TOF MR angiography is not reproducible or sensitive enough comparing to that of renal artery CT angiography.

关 键 词：高血压 肾动脉狭窄 肾动脉螺旋CT血管成像 非增强磁共振血管造影时间飞跃法 

分 类 号：R816.7[医药卫生—放射医学] R445.2[医药卫生—临床医学]