MR时间分辨对比剂动态显像技术评价足背动脉及第一跖背动脉的可行性  

Feasibility study of MR time-resolved imaging of contrast kinetics sequence in evaluation of the dorsalis pedis artery and the first dorsal metatarsal artery

作　　者：孙博[1] 董越[1] 宁殿秀[1] 宋清伟[1] 孙美玉[1] 

机构地区：[1]大连医科大学附属第一医院放射科,116011

出　　处：《中华放射学杂志》2014年第2期139-142,共4页Chinese Journal of Radiology

摘　　要：目的 探讨MR时间分辨对比剂动态显像（TRICKS）技术在足背动脉、第一跖背动脉及在趾蹼处分支成像中可行性.方法 回顾性分析43例临床怀疑足踝软组织病变行TRICKS技术扫描的患者资料,对图像采用MIP方法进行后处理.由2名高年资MR诊断医师单独对足背动脉、第一跖背动脉及分支的显示评分,并对2名医师的评分进行一致性分析,对于评分不一致的患者协商获得最终评分结果.对影像质量评分≥2分的患者,评估第一跖背动脉的临床分型,共分为浅表型、肌内型、肌下型和缺如型4型；按第一跖背动脉中点血管口径的大小分为大型、中型和小型3型；按第一跖背动脉在趾蹼处进入第一、二趾的分支口径分成分叉型、主干型和细支型3型.结果 2名医师对足背动脉、第一跖背动脉及分支影像的评分具有高度一致性（Kappa值=0.895,P＜0.05）,TRICKS技术可以较好显示足背动脉及其分支的动态充盈情况,最终协商获得的评分为：8例4分、22例3分、8例2分、5例1分.对评分≥2分的38例第一跖背动脉进行临床分型：（1）解剖位置分型：8例浅表型、23例肌内型、7例肌下型,无缺如型；（2）按第一跖背动脉中点血管口径分型：2例大型、25例中型、11例小型.（3）对30例（图像评价3、4分）显示第一跖背动脉在趾蹼处进入第一、二趾分支按口径分型：11例分叉型、5例主干型、14例细支型.结论 TRICKS技术可以很好显示足背动脉、第一跖背动脉及分支,为评估第一跖背动脉血管分型提供有价值的信息.Objective To investigate the feasibility of MR angiography of the dorsalis pedis artery （DPA）,the first dorsal metatarsal artery （FDMA） and the branches at the first toe web by threedimensional time-resolved imaging of contrast kinetics （TRICKS） sequence.Methods Forty three patients with suspected or known soft tissue diseases of the ankle and foot were examined retrospectively by MR TRICKS sequence.Two experienced radiologists independently evaluated the visualization performance of DPA,FDMA and its branches with maximum intensity projection.Kappa analysis was performed for the image evaluation of the two radiologists.Consensus scores were obtained if the two radiologists had different scores.Clinical classification of FDMA was carried out for patients with scores equal to,or more than 2 points after imaging evaluation.FDMA was categorized according to its location （superficial,intramuscular,infra-muscular,absent）,diameter （large,medium and small） and branching pattern at the toe web （ramifying type,main trunk type and fine small branch）.Results The scoring results of the two radiologists indicated a high agreement （Kappa value =0.895,P 〈 0.05）.TRICKS images can clearly show the arterial filling of DPA,FDMA and its branches.The final consensus scores were as follows：8 patients had 4 grade and 22 patients 3 grade,8 patients 2 grade and 5 patients 1 grade.Clinical classification of FDMA for 38 patients（arterial scales ≥2 point）：（1） Location：superficial （8 patients）,intramuscular （23 patients）,intramuscular （7 patients） ; （2） Diameter at the midpoint of FDMA：large （2 patients）,medium （25 patients）,and small （11 patients）; （3）Branching pattern at the toe web：ramifying type （11 patients）,main trunk type （5 patients）,fine branch （14 patients）.Conclusion MR TRICKS sequences are valuable in the evaluation of the DPA and FDMA and its branches,which can provide useful anatomical information for classification of FDMA.

关 键 词：足背动脉 磁共振血管造影术 图像处理 计算机辅助 

分 类 号：R445.2[医药卫生—影像医学与核医学] R658[医药卫生—诊断学]