多种MR血管造影对四肢血管性疾病和血管狭窄模型的应用研究  

Evaluation of CE MRA、MCA and 2D TOF MRA for peripheral vascular disease:an in vitro experiment and clinic application

作　　者：徐海波[1] 孔祥泉[1] 杨亚莉[1] 肖学宏[1] 熊茵[1] 刘定西[1] 杨帆[1] 于群[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《中华放射学杂志》2001年第9期708-712,共5页Chinese Journal of Radiology

摘　　要：目的　通过多种MR血管造影技术在模拟狭窄血管的体外模型和四肢血管性疾病中的应用分析 ,评估其价值和限度。方法　 (1 )实验研究 :对不同狭窄程度、长度的模型行二维时间飞跃磁共振血管造影 (2DTOFMRA)、幅度对比磁共振血管造影 (MCA)、增强 (CE)MCA和三维增强磁共振血管造影 (3DCEMRA) ,测量并计算狭窄程度、长度及其对狭窄程度评估的准确性。 (2 )临床应用 :对2 0例四肢血管性疾病的患者行 3DCEMRA、2DTOFMRA和MCMCA ,其中血管瘤 1 2例 ,动脉粥样硬化4例 ,假性动脉瘤 1例 ,脂肪瘤 1例 ,骨转移瘤 1例 ,动脉破裂修补术 1例 ,均经手术病理证实。比较上述MRA的图像质量和血管显示情况。结果　 (1 )实验结果 :2DTOFMRA、MCA、CEMCA和 3DCEMRA对管腔狭窄程度为 69%的分级准确性分别为 3 6 4%、9 1 %、1 8 2 %和 72 7% ,3DCEMRA对狭窄>69%的评估优于其他MRA方法 (P <0 0 0 1 ) ,但比起真实值仍有高估 (P <0 0 0 1 )。 (2 )临床应用 :2DTOFMRA、MCA和 3DCEMRA的动脉显示率分别为 92 6% ,94 4%和 98 1 % ;对 1 2例血管瘤的异常血管显示分别为 0例、6例和 1 1例。结论　 3DCEMRA无论对图像质量、狭窄程度的评估还是对病灶的供血血管及病灶与血管关系的显示均具有明显优势 ,但对狭窄程度的高估仍不可避免。Objective To evaluate the value and limitation of different magnetic resonance angiography (MRA) sequences in detecting vascular diseases by means of study on arterial stenotic model in vitro and clinical application in peripheral vascular diseases. Methods (1)In vitro study: two dimensional(2D) time of flight、magnitude contrast(with/without Gd DTPA)and 3D contrast enhanced MRA were performed for nonpulsatile stenotic model in vitro. The results of MRA in detection of the degree and length of stenosis were measured and compared with the findings of conventional angiography(CA) and real values. (2)Clinical application: 3D CE MRA, 2D TOF MRA and MC MCA were performed in 20 patients with vascular disease in extrimity. A comparative study of image quality in different MRA sequences and vessels′ detection was made. Results (1)In vitro study: The grading accuracy of 2D TOF MRA、MCA、CE MCA and 3D CE MRA for significant stenosis(69%)was 36 4%,9 1%,18 2% and 72 7%,respectively. 3D CE MRA was superior to other MRA methods in assessment of the degree of significant stenosis(>69%)( P <0 001)and still overestimated the stenosis compared to the real values( P <0 001). (2)Clinical application: The arterial detected rate of 2D TOF MRA,MCA and 3D CE MRA was 92 6%,94 4% and 98 1%,respectively. 2D TOF MRA、MCA and 3D CE MRA demonstrated 0, 6 and 11 of the 12 hemangiomas, respectively. Conclusion 3D CE MRA is markedly superior to other MRA techniques in the image quality, stenosis assessment and demonstration of feeding artery. And overestimation of the stenosis is still unavoidable.

关 键 词：磁共振血管造影术 外周血管疾病 四肢 医学实验 

分 类 号：R445.2[医药卫生—影像医学与核医学]