三维增强磁共振血管造影(60例临床应用分析)  

Three dimensional dynamic contrast enhanced MR angiography:an analysis of clinical applications on 60 cases

作　　者：宋金松[1] 刘玉清[1] 朱杰敏[2] 俞肖一[2] 凌坚[1] 严洪珍[2] 蒋世良[1] 

机构地区：[1]中国医学科学院 [2]北京协和医院放射科

出　　处：《中华放射学杂志》1999年第9期602-605,共4页Chinese Journal of Radiology

摘　　要：目的　探讨三维增强磁共振血管造影 ( 3DDCEMRA)技术及其临床应用价值。方法60例 3DDCEMRA包括 4 4例病变血管和 16例正常血管。选用三维快速梯度回波 ( 3DFFE)序列 ,行3DDCEMRA检查 ,主要参数为TR 9毫秒 ,TE 3毫秒 ,翻转角 3 0° ,矩阵 12 8× 2 5 6,快速注射 0 2mmol/kg钆 喷替酸葡甲胺 (Gd DTPA) ,注射速度 1 5～ 2 0ml/s ,延迟时间依据病情而定 ,其中 3 6例 (病变组 3 4例和正常组 2例 )经数字减影动脉血管造影 (IADSA)或 (和 )手术证实 ;图像质量采用优、良、差 3级评价 ,并计算出敏感性、特异性和准确性。结果　 60例 3DDCEMRA图像质量优良者 5 7例 ,占 95 %。5 0例 ( 16例正常组与经手术、IADSA证实的 3 4例病变组 ) 3DDCEMRA的敏感性、特异性和准确性分别为 94 1%、87 5 %和 92 0 % ;假阳性 ,假阴性各 2例 ,病变程度高估 3例。 3 4例各类血管和相关病变的 3DDCEMRA结果与IADSA或 (和 )手术符合率为 85 3 % ,主动脉及其主支病变则分别为 10 0 0 %和77 3 %。结论　 3DDCEMRA是一种有效、微创技术 ,评价主动脉病变可与IADSA媲美 ,对主动脉主支病变与IADSA尚有一定差距 ,通过提高扫描速度和改善重建技术 ,有望能逐步替代IADSA。Objective To evaluate the technique and assess the value of clinical applications of 3D dynamic contrast enhanced MR angiography in the diagnosis of lesions of the aorta and its major branches Methods 3D DCE MRA was performed in 60 cases, 44 of them had various aortic and major branch lesions and 16 normal finding The imaging sequence was FFE 3D(3D fast field echo),and the parameters used were TR: 9 ms, TE:3 ms, flip angle 30°, and matrix 128×256 The 0 2mmol/kg Gd DTPA was injected with the rate of 1 5-2 0 ml/sec, and the delay time was determined on the basis of status of patients The image quality was evaluated and the results in 34 cases of 3D DCE MRA were compared with that of IADSA or/and surgery Results Fifty seven (95%) cases were classified as good image quality in 60 cases of our series, and sensitivity, specificity and accuracy of 3D DCE MRA in the diagnosis of 50 cases with the aortic and its major branch lesions were 94 1%, 87 5% and 92 0% respectively, and fasle postive in 2, fasle negative in 2, overestimation in 3 ccuracy of 3D DCE MRA of 34 patients proved by IADSA or/and surgery was 100% in aortic and 77 3% in major branch lesions and the overall accuracy was 85 3% Conclusions 3D DCE MRA is an effective and minimally invasive method for evaluating lesions of aorta ,and almost of similar efficacy to that of IADSA However, the diagnostic evaluation of the major branch lesions is rather inferior to that of IADSA Along, with fasting scanning speed and improvement of three dimensional reconstruction techinique, angiography including DSA will possibly and progressively be replaced by 3D DCE MRA in the near future

关 键 词：磁共振血管造影 图像增强 临床应用 血管疾病 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.04[医药卫生—诊断学]