摘要
目的:评价三维对比增强MRA在下肢动脉病变血管成像中的临床价值。方法:68例接受手术治疗的下肢动脉病变患者,术前全部行双下肢动脉三维对比增强MRA检查,根据重建后图像对下肢血管病变进行评估并采取不同的手术方式。将术前检查结果与手术结果进行对照分析。结果:双下肢主干动脉在三维对比增强MRA成像中均获得满意的显示,正常血管显示率100%,三维对比增强MRA明确显示下肢病变血管的部位、范围及血管病变程度,与术中诊断符合率为95%(65/68)。结合血管超声的检查结果,诊断符合率达99%(67/68)。其显示小腿胫前和/或胫后动脉二级以上分支血管时显影欠佳,但对手术方式及疗效无影响。结论:三维对比增强MRA应用于下肢动脉病变的术前特异性检查,具有定位准确、无医源性损伤、安全迅速及可重复进行等优越性,是外科治疗下肢动脉疾病及术后随访的重要依据,具有广阔的临床应用前景。
Abstract
Objective: To evaluate the clinical value of three dimensional contrast enhanced MRA(3D-CE-MRA) in the imaging of the diseased arteries in lower extremities. Methods: Sixty-eight cases of arterial diseases or trauma of lower extremities received 3D-CE-MRA with a bolus injection of 30ml Gd-DTPA via antecubital vein before operation. Different surgeries were performed on the lower extremities based on the imagings which were harvested by MIP reconstruction workstation. The diagnosis of 3D-CE-MRA before operation were compared with the results of vascular reconstruction surgeries of lower extremities. Results: Satisfactory images of the main arteries of the lower extremities were achieved by 3D-CE-MRA, with the demonstrating rate of 100%. The location, extension and degree of the arterial lesions could be clearly revealed on the 3D-CE-MRA images, and the diagnosis of 3D-CE-MRA were 95%(65/68) in accord with the surgical outcomes. Combining with Doppler ultrasonic examination of vascular diseases, the correct rate of clinical diagnosis of 3D-CE-MRA reached 99%(67/68). Meanwhile, the second branches of anterior tibial arteries and/or posterior tibial arteries were not well demonstrated on 3D-CE-MRA images, however, this had no influence on surgical options and its outcomes. Conclusions: 3D-CE-MRA could play an important role in the diagnosis and follow-up of the arterial diseases of lower extremities with such advantages as accuracy, non-invasion, safety, rapidness and reproducibility. It is especially valuable in arterial surgerical planning and has big clinical significance.
关键词
动脉硬化 /
闭塞性 /
血栓性脉管炎 /
闭塞性 /
磁共振血管造影术
Key words
arteriosclerosis obliterans /
thromboangiitis obliterans /
magnetic resonance angiography
马 中;边杰芳;张聚良;王 岭;常英娟;贺洪德.
三维对比增强MRA在下肢动脉病变血管成像中的临床应用[J]. 中国临床医学影像杂志. 2006, 17(5): 282-284
MA Zhong;BIAN Jie-fang;ZHANG Ju-liang;WANG Ling;CHANG Ying-juan;HE Hong-de.
Clinical application of 3D-CE-MRA in the imaging of the diseased arteries in lower extremities[J]. Journal of China Clinic Medical Imaging. 2006, 17(5): 282-284
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