左、右侧肘静脉注射法对颈部三维对比增强磁共振动脉血管成像的影响  

The Effects of Left or Right Sided Cubital Intravenous Injection on the Carotid Artery Imaging with Three Dimensional Contrast Enhanced Magnetic Resonance Angiography

作　　者：毛存南[1] 孙军[1] 刘林栋[1] 杨眉[1] 徐青青[1] 殷信道[1] 

机构地区：[1]南京医科大学附属南京医院放射影像科,210006

出　　处：《临床放射学杂志》2013年第11期1565-1569,共5页Journal of Clinical Radiology

摘　　要：目的探讨左、右侧肘静脉注射对比剂对颈部三维对比增强磁共振动脉血管成像(3D-CEMRA)的影响。方法 120例临床怀疑颈动脉或椎动脉狭窄并要求颈部MRA检查的患者,按对比剂注射部位随机选择分成左侧肘静脉(A组,n=60)和右侧肘静脉(B组,n=60)两组。使用菲利浦Achieva 3.0 TX磁共振成像仪及其配备的头颈部16通道线圈进行颈部3D-CEMRA成像,观察有无颈静脉对比剂返流,测量颈动脉信噪比和主动脉弓前间距,并采用SPSS 15.0软件对两组间的差异进行统计学分析。结果 A组测得的颈动脉信噪比(192.5±71.3)明显低于B组(235.1±61.6),A组出现颈静脉返流的例数(7例)较B组(1例)高,两者之间比较有显著统计学意义(t=3.71,P<0.05;χ2=4.32,P<0.05);颈静脉返流患者主动脉弓前间距为(12.8±0.3)mm,无颈静脉返流患者主动脉弓前间距为(19.1±0.8)mm,两者之间比较有显著的统计学意义(t=13.24,P<0.01)。在A组中,高血压对颈静脉返流影响比较有统计学意义(χ2=5.09,P<0.05)。结论在颈部3D-CEMRA中,尤其是高血压的患者,左侧肘静脉注射及主动脉弓前间距与颈静脉返流密切相关;右侧肘静脉注射显著降低颈静脉返流现象,增加图像信噪比,提高3D-CE MRA成像质量。Objective To investigate the effects of left or right sided cubital intravenous injection on the carotid artery imaging with three dimensional contrast enhanced magnetic resonance angiography. Methods 120 cases of clinical suspi cion carotid and vertebral artery stenosis received three dimensional contrast enhanced magnetic resonance angiography（3D CEMRA）. According to the contrast agent injection site selected, all cases were randomly divided into group A （left sided cubital intravenous injection） and group B （right sided cubital intravenous injection）. Philip Achieva 3.0 TX MR equipe ment with 16 channel head and neck coil was used for cervical 3D CEMRA. Whether or not contrast agent reflux to jugular vein was observed, and the carotid signal to noise ratio and the anterior space of aortic arch were measured. Results The carotid signal to noise ratio in group A（ 192.5 ±71.3） mm was significantly lower than that in the group B （235.1 ±61.6） mm, but the number of jugular vein reflux （7 cases ） in group A was higher than that of group B （ 1 case ）, significant differences were seen in two groups （t = 3.71, P 〈 0.05, X2 = 4.32, P 〈 0.05）. The anterior space of aortic arch was （12.8 ± 0.3 ）mm in cases with jugular vein reflux, and（ 19.1± 0.8 ）mm in cases without jugular vein reflux, statistical significance was observed （ t = 13.24, P 〈 0.01 ）. In group A, high blood pressure affected the jugular vein reflux（ X2 = 5.09,P 〈 0.05 ）. Conclusion In the carotid 3 D CEMRA, especially in patients with high blood pressure, both of left si ded cubital intravenous injection and the anterior space of aortic arch are closely related to jugular vein reflux. Right sided cubital intravenous injection can significantly reduce jugular vein reflux phenomenon, and also increase the signal to noise ratio （SNR） and quality of the carotid artery imaging.

关 键 词：对比剂 磁共振血管造影 静脉返流 

分 类 号：R445.2[医药卫生—影像医学与核医学]