增强MRA在急性肺栓塞诊断中的应用  

Contrast-enhanced MR Angiography──Its Clinical Application in Diagnosing Acute Pulmonary Embolism

作　　者：蒋涛[1] 翟仁友[1] 曹保信[1] 李莹[1] 翟晓力[1] 刘晓娟[1] 姜桦[1] 钱晓军[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院放射科,100020

出　　处：《临床放射学杂志》2000年第9期559-562,共4页Journal of Clinical Radiology

摘　　要：目的　评价增强磁共振血管造影 (CEMRA)诊断急性肺栓塞的价值。材料与方法　对 11例疑有急性肺栓塞的患者进行肺部DSA和CEMRA检查。CEMRA检查时 ,嘱患者屏气 ,于静脉内团注钆 喷替酸葡甲胺 (Gd DTPA)对比剂后行肺动脉期扫描 ,用3D自由感应衰减的射频扰相稳态梯度召唤回波序列采集图像。所有CEMRA图像由 2位MR诊断医师独立评估 ,并与DSA诊断结果对比。结果　 11例患者中 ,DSA发现 11例 3 1个栓子 ,CEMRA发现 10例 2 8个栓子 ,肺动脉栓塞的CEMRA诊断指征 :( 1)直接征象 :中心性充盈缺损 ( 8处 )、边缘性充盈缺损 ( 14处 )、完全闭塞 ( 2处 ) ;( 2 )间接征象 :血管减少、肺灌注降低和明显的肺动脉主干扩张。结论　CEMRA是急性肺栓塞的一种无损伤性、无放射性和不必应用碘对比剂的诊断方法。Objective To evaluate contrast enhanced MRA (CE MRA) in diagnosing acute pulmonary embolism (PE).Materials and Methods A total of 11 consecutive patients with suspected PE underwent both DSA and CE MRA. CE MRA was performed during suspended respiration at pulmonary arterial phase after intravenous bolus injection of gadolinium. A steady state gradient recalled echo sequence with 3D of free induction decay sampling technique was used.Results A total of 31 acute pulmonary emboli were depicted in 11 patients on DSA, while 28 of these emboli were depicted in patients on CE MRA. The CE MRA features of PE had direct signs and indirect signs. The direct signs were as follows: (1) central filling defect (n=8), (2) mural filling defect (n=14) and (3) total occlusion (n=2). The indirect signs included decreased vascularity, reduced pulmonary perfusion and marked dilatation of main pulmonary artery.Conclusion No radiation hazard and needless of using iodinated contrast media, CE MRA is a helpful non invasive technique for the diagnosis of PE.

关 键 词：急性肺栓塞 磁共振血管造影 增强MRA 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]