非对比剂QISS-MRA对肾功能不全患者下肢动脉硬化的诊断价值  

Value of non-contrast enhanced quiescent interval single shot(QISS)MRA in the diagnosis of lower extremity arteriosclerosis in patients with renal insufficiency

作　　者：吴刚[1] 张晓莉[1] 李小明 WU Gang;ZHANG Xiao li;LI Xiao ming(Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Chin)

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《放射学实践》2018年第7期750-753,共4页Radiologic Practice

基　　金：国家自然科学基金(81571643)

摘　　要：目的:评估基于静态间隔单次激发(QISS)的非对比剂MRA对肾功能不全患者下肢动脉硬化的诊断价值。方法:选取肾功能不全合并下肢动脉硬化的患者25名,进行无需对比剂的下肢QISS-MRA检查。QISS采用心电门控技术,扫描范围覆盖腹主动脉远端至小腿动脉远端。对QISS成像的图像质量进行主观评分。把全下肢动脉分为17个节段分别进行图像质量分析。QISS成像的每个节段的图像质量进行评分标准如下:0=差;1=中;2=良;3=优。对下肢动脉的各个节段分别进行动脉狭窄评分(0为无狭窄;1为狭窄程度<50%;2为狭窄程度≥50%;3为亚节段闭塞;4为全节段闭塞)。患者的动脉狭窄总评分等于各节段狭窄评分的总和。比较有症状组和无症状组下肢动脉狭窄评分差异。结果:全部患者顺利完成下肢动脉非对比剂QISS成像。QISS的主观图像质量评分平均值为2.63,接近优。25名患者下肢动脉狭窄评分为2~27分,中位数为14分。有症状组(n=14)的评分为9~27分,中位数为18分。无症状组(n=11)的评分为2~11分,中位数为8分。有症状组狭窄评分显著高于无症状组(P<0.001)。两组的年龄、性别差异无统计学意义(P>0.05)。结论:非对比剂QISSMRA成像可以用于诊断肾功能不全患者的下肢动脉硬化。Objective：To evaluate the feasibility of non-contrast enhanced QISS-MRA in the diagnosis of lower extremity arteriosclerosis in patients with renal insufficiency.Methods：25 patients with renal insufficiency and lower extremity arteriosclerosis were enrolled in this prospective study for non-contrast enhanced QISS-MRA.ECG gating QISS was used.The area from distal end of abdominal aorta to lower part of calf arteries was covered.The quality of QISS-MRA images was subjectively scored.The lower extremity artery tree was divided into 17 arterial segments in this study for the evaluation of image quality.Each segment on QISS-MRA was given an image quality score as 0=poor,1=moderate,2=good,3=excellent.Score for stenosis was given for each segment as 0,normal;1,stenosis extent 50%;2,stenosis extent≥50%;3,sub-segmental occlusion;4,full-segmental occlusion.The arteriosclerosis score for a patient was equal to the summation of all segments.The arteriosclerosis score of symptomatic patients and that of asymptomatic patients were compared.Results：All patients had the non-contrast enhanced QISS-MRA of lower extremity completed smoothly.The mean subjective image quality score of QISS-MRA was 2.63 which was close to the score ＂excellent＂.The arteriosclerosis score of all the 25 patients ranged from 2 to 27,with a median as 14.The score for symptomatic group（n=14）ranged from 9 to 27,with a median as 18.The score for asymptomatic group（n=11）ranged from 2 to 11,with a median as 8.Arteriosclerosis score was significantly higher in the symptomatic patients compared with that in the asymptomatic patients（P〈0.001）.Age and sex were not significantly different between the two groups（P〉0.05）.Conclusion：Non-contrast enhanced QISS-MRA is able to diagnose lower extremity arteriosclerosis in patients with renal insufficiency.

关 键 词：静态间隔单次激发 磁共振血管成像 非对比剂 下肢动脉硬化 肾功能不全 

分 类 号：R445.2[医药卫生—影像医学与核医学]