非增强磁共振血管成像与超声检查对肾功能不全患者肾动脉狭窄程度诊断价值的对比研究  

Comparative study of the diagnostic value of non-enhanced magnetic resonance angiography and ultrasound in the degree of renal artery stenosis in patients with renal insufficiency

作　　者：赵龙[1] 李国奇 孟凡宇 刘家祎[1] 范占明[1] ZHAO Long;LI Guoqi;MENG Fanyu;LIU Jiayi;FAN Zhanming(Department of Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所医学影像科,100029 [2]首都医科大学国际合作办公室 [3]航天海鹰安全技术工程有限公司节能环保事业部

出　　处：《心肺血管病杂志》2021年第3期265-269,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:用非增强磁共振血管成像(NCE-MRA)评估肾功能不全患者肾动脉狭窄程度,并与肾动脉超声进行对比,分析NCE-MRA与超声对肾动脉狭窄诊断的一致性。方法:使用西门子3.0T磁共振机对37例肾功能不全合并肾动脉狭窄患者进行基于TrueFISP序列的两个不同参数的NCE-MRA检查,通过重建得到显示肾动脉的冠状位图像,由2名有经验的影像科医生分别单独进行肾动脉NCE-MRA的图像质量及肾动脉狭窄程度的判断,并分别对两组肾动脉成像的图像质量、肾动脉狭窄程度、NCE-MRA与肾动脉超声的一致性进行分析。结果:两个不同参数的NCE-MRA图像质量评分均较高(>3.5),且两序列间及两医生间的一致性均较高(Kappa系数=0.898,P<0.001)。37例患者的74支肾动脉狭窄程度在两位医生间的评价一致性很高(Kappa系数=0.951,P<0.001),且与肾动脉超声的一致性也较高(Kappa系数=0.87,P<0.001)。结论:肾动脉NCE-MRA是一种有效的无创、不使用对比剂、无电离辐射的血管成像方法,能正确诊断肾动脉狭窄程度,并提供较超声更为全面的影像学信息,是肾功能不全患者不能接受增强检查时的较理想的替代方式之一。Objective: Non-contrast-enhanced magnetic resonance angiography(NCE-MRA) was used to evaluate the degree of renal artery stenosis in patients with renal insufficiency comparing with renal artery ultrasound, so as to analyze the consistency of NCE-MRA and ultrasound in the diagnosis of renal artery stenosis. Methods: 37 patients with renal insufficiency and renal artery stenosis underwent NCE-MRA examinations based on the TrueFISP technique with two sequences of different parameters by the Siemens 3.0 T MRI machine. Acquisition of coronary images of renal artery was achieved by reconstruction. Two independent experienced radiologists analyzed the NCE-MRA image quality and the degree of renal artery stenosis. Agreements of two sequences in image quality, degree of renal artery stenosis were analyzed while agreement of NCE-MRA and ultrasound result was analyzed. Results: The NCE-MRA image quality score of the two sequences with different parameter was considerably high(>3.5). The consistency between the two sequences and between the two radiologists was excellent(Kappa coefficient=0.898,P<0.001).The degree of stenosis of 74 renal arteries in 37 patients was highly consistent between the two doctors(Kappa coefficient=0.951,P<0.001). The NCE-MRA was also highly consistent with renal artery ultrasound(Kappa coefficient=0.87,P<0.001). Conclusions: Renal artery NCE-MRA is an effective non-invasive, non-contrast agent, non-ionizing radiation angiography method, which can correctly diagnose the degree of renal artery stenosis and provide more comprehensive imaging information than ultrasound, and is one of the ideal alternatives for patients with renal insufficiency who cannot afford enhanced imaging examination.

关 键 词：非增强磁共振血管成像 肾功能不全 肾动脉狭窄 

分 类 号：R54[医药卫生—心血管疾病]