三维CE-MRA对主动脉肺动脉疾病的诊断价值

Diagnostic value of three-dimensional CE-MRA to aortic and pulmonary disease

目的:探讨三维CE-MRA对主、肺动脉疾病的诊断价值。方法:对26例(其中主动脉夹层12例,肺动脉栓塞14例)临床拟诊为主动脉夹层或肺动脉栓塞的患者进行三维MRA检查。取心电门控超高速3D-FLASH(3D Fast Low Angle Shot)序列,以最大强度投影法获得3D-MRA。结果:12例主动脉夹层均能很好显示,14例肺动脉栓塞,13例显示肺栓塞的部位、范围。急性肺栓塞的直接征象为截断征、双轨征;慢性肺动脉栓塞主要表现为肺动脉管腔内偏心性和附壁性充盈缺损,1例亚段以下未能显示。结论:3D-MRA是一种无创性检查主、肺动脉栓塞的有效方法,可重建直观的三维肺血管树,可较清晰地显示亚段以上血管情况,但对外周细小血栓的诊断受局限。

Objective ：To probe the diagnostic value of three-dimensional CE-MRA to aortic and pulmonary disease.Methods：26 patients （12 cases of aortic dissection, 14 cases of pulmonary embolism） were examined by three-dimensional CE-MRA for suspected aortic dissection or pulmonary embolism. Taking the sequence of ECG gated ultra-high-speed 3D-FLASH （3D fast low angle sho0,using methods of the most strength projection to get 3D-MRA. Results： 12 patients showed well aortic dissection, 14 patients showed pulmonary embolism, 13 patients showed the site and range of pulmonary embolism. Acute pulmonary embolism direct signs were cut off sign and two track sign;chronic pulmonary embolism showed mainly eccentric and mural filling defect of pulmonary lumen .1 patient was not showed under sub-segment. Conclnsion：3D-MRA is effective way of non-invasive examining aortic and pulmonary embolism. It can rebuild visual three-dimensional pulmonary vascular tree, and more clearly show vascular condition above sub-segment. But it is limitation to diagnose peripheral small thrombosis.