三维动态增强磁共振血管造影诊断肺隔离症的价值  

Diagnostic value of three-dimensional dynamic contrast-enhanced MRA on pulmonary sequestration

作　　者：徐海波[1] 孔祥泉[1] 杨帆[1] 熊茵[1] 刘定西[1] 于群[1] 柳曦[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》2002年第1期62-64,共3页Chinese Journal of Radiology

摘　　要：目的　评估三维动态增强磁共振血管造影 (3DDCEMRA)对显示肺隔离症异常血管的价值。方法　 5例肺隔离症患者作了胸部正侧位片、CT和MRI检查后 ,均行胸部和上腹部 3DDCEMRA检查 ,并进行最大信号强度投影 (MIP)和多平面重建 (MPR)。结果　 5例肺隔离症均为肺叶内型 ,位于左肺下叶。胸片表现隔离的肺组织均位于左下叶 ,呈圆形或椭圆形、密度较均匀的团块影。CT示降主动脉后方软组织密度肿块 ,2例肿块周围伴有肺气肿。增强CT显示了 2例供血动脉。平扫MRI示隔离肺组织在T1WI和T2 WI较正常肺组织信号高的软组织块影 ,并显示了 3例供血动脉 ,但未能显示其全貌、行程、分支及引流静脉。另 2例异常供血动脉未能显示。而 3DDCEMRA均显示了其异常供血动脉和引流静脉 ,并清楚显示了其分支和行程 ,与术中所见完全一致。结论　 3DDCEMRA能较好地显示肺隔离症的异常供血动脉和引流静脉 ,有利于确诊此病和制订手术治疗方案。Objective To evaluate the efficacy of three-dimensional dynamic contrast-enhanced MR angiography (3D DCE MRA) in demonstrating the abnormal blood vessels of pulmonary sequestration. Methods Five patients of pulmonary sequestration underwent 3D fast imaging with steady state precession (FISP) using contrast medium and breath holding following chest radiography, CT, and MR scans. The reconstructed MR angiography was performed using maximum intensity projection (MIP) and multiplanar reconstruction (MPR) techniques. Results Five patients with intralobar sequestration in the left lower lung were confirmed by surgical findings. The chest radiograph showed pulmonary sequestration as a persistent area of opacity in the posterior basal segment of the left lower lobe, which was close to mediastinum in 2 cases and close to diaphragm in 3 cases. CT revealed a soft tissue mass beyond descending aorta and lobar emphysema around the pulmonary sequestration,and the supplying vessel was documented in 2 cases on enhanced CT. MRI demonstrated a hyperintensity mass with respect to normal lung parenchyma and the supplying vessel in 3 cases, but its course, branches,and the draining vessels,as well as the supplying vessel in another 2 cases were not shown on MRI. The reconstructed CE MRA using MIP or MRP techniques clearly showed the supplying vessel, its course, branches, and draining vessels, which was identically found at surgery. Conclusion 3D DCE MRA is useful in demonstrating the supplying and draining vessels to pulmonary sequestration in a way that can provide the diagnosis and aid in surgical planning without the need for DSA.

关 键 词：支气管肺隔离症 磁共振血管造影术 图像增强 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学]