下腔静脉膜性阻塞高场MRI动态增强与数字减影血管造影的对比研究

Comparative study on DSA and dynamic contrast enhanced MRI in the diagnosis of membranous obstruction of inferior vena cava

目的探讨3.0TMRI动态增强检查对下腔静脉膜性阻塞(MOVC)的MRI诊断价值。方法对比分析41例Budd-Chiari综合征患者(BCS)MRI与DSA图像,评价MRI动态增强扫描在判断下腔静脉膜性梗阻平面、端口形态及梗阻膜厚度的介入术前诊断价值。结果 41例BCS患者中下腔静脉膜性阻塞34例(其中4例膜性带孔),非膜性阻塞7例,MRI动态增强与DSA诊断有较好的吻合度;MRI对MOVC术前诊断灵敏度(76.4%)、特异度(71.4%)较高。IVC梗阻膜远心端形态MRI与DSA显示差别不大。IVC梗阻膜以等、低信号为主;厚度以<1cm多见(53.8%)。结论 MRI对下腔静脉膜性梗阻部位、端口形态及梗阻膜厚度的术前显示有优势,对介入治疗方案的术前制订能提供有效信息。

Objective To investigate the value of dynamic contrast enhanced MRI(DCE-MRI) in diagnosing membranous obstruction of inferior vena cava(MOVC).Methods DCE-MRI images of 41 patients with Budd-Chiari syndrome(BCS) were retrospectively compared with IVC angiography to evaluate the adventages of DCE-MRI before operation in distinguishing the obstruction level,port shape and thickness of the membrane.Results The DCE-MRI had similar imaging effect compared with DSA,they had a certain degree of agreement.34 patients were membranous obstruction(4 with hole),7 patients were without membrane.The sensitivity and specificity of DCE-MRI preoperative diagnosis were 76.4% and 71.4%.The morphology of distal interface of membrane displayed by DCE-MRI was similar to DSA.Iso-signal(38.5%) and low signal(57.7%)were dominated in the membranes.The thicknesses of membranes were often less than 1 cm(53.8%).Conclusions The DCE-MRI has significant value in diagnosing MOVC before operation which can wholly show the position,shape and thickness of the membrane of MOVC.