动脉导管未闭伴肺动脉高压的SE、Cine MRI和MRA诊断

SE、Cine MRI and MRA Diagnosis of PDA with Pulmonary Hypertension

目的：报道ＳＥ、ＣｉｎｅＭＲＩ和ＭＲＡ对动脉导管未闭（ＰＤＡ）伴肺动脉高压的诊断价值。材料和方法：６例心超诊断ＰＤＡ不明确女性行ＭＲＩ检查。均采集横断、冠状、矢状、主动脉和左室长轴ＳＥＴ１Ｗ像，４例尚获斜冠／矢状面ＳＥＴ１Ｗ像；ＣｉｎｅＭＲＩ采集主动脉、左室长轴和斜冠／矢状面像，１例还获冠状面像；２ＤＰＣ结合ＥＣＧ门控采集主动脉长轴或矢状面像，４例同时获３ＤＰＣ像。结果：６例ＰＤＡ均经手术或造影证实。横断面ＳＥ未能直接显示ＰＤＡ，４例斜冠状面（平行于肺动脉主干）ＳＥ显示ＰＤＡ；５例ＣｉｎｅＭＲＩ直接显示ＰＤＡ，１例ＣｉｎｅＭＲＩ间接提示ＰＤＡ；２Ｄ／３ＤＰＣ则全部显示；５例伴肺动脉高压者ＳＥ和ＣｉｎｅＭＲＩ均显示其征象，且以后者为佳；对伴随的主动脉瓣和／或二尖瓣返流仅ＣｉｎｅＭＲＩ显示。结论：初步经验表明斜冠状面ＳＥ、ＣｉｎｅＭＲＩ和ＰＣＭＲＡ对ＰＤＡ伴肺动脉高压病例具有重要诊断价值。

urpose:To report the value of SE、Cine MRI and MRA in the diagnosis of PDA with pulmonary hypertension.Materials and Methods:Six females suspected of having PDA by Echocardiography with ages of 2.5、13、29、42、59 and 63 years old were examined on a GE Vectra 0.5T superconductive magnet system.Axial、coronal、sagittal and the long axis sections of the aorta and LV in six cases and the oblique-coronal or sagittal images in four cases were acquired with ECG-Gating SE pulse sequence,the long axis sections of the aorta and LV as well as the oblique coronal or sagittal images were obtained with 2D PC with ECG-gating in all six cases and 3D PC MRA images were acquired in four cases simultaneously.Results:In the six surgical or angiography-proven PDA cases,no positive one could be directly shown on axial SE T1WI,four were shown on oblique-coronal SE T1WI,five were demonstrated by Cine MRI,all six cases were displayed by 2D/3D PC MRA.The associated pulmonary artery hypertension in five cases was shown well by SE and better by Cine MRI technique.The associated aortic valve regurgitation in four cases and the mitral valve regurgitation in two cases were demonstrated well by Cine MRI.Conclusion:Our preliminary experiences showed that oblique-coronal SE T1WI、Cine MRI and PC MRA could be very useful in the direct demonstration of PDA and its associated pulmonary artery hypertension.