不同技术及其临床应用进展——重点探讨颈、肾、髂及肺动脉血管MRA成像

The Advance in Technique and Clinical Application of Different MR Angiography——Emphasis on Carotid ,Renal,lliac and Pulmonary Artery Imaging

共振血管造影于 1985年开始用于临床。因其无创,敏感性高,现已广泛应于用头、颈及四肢的血管造影。但在遇到不同血流类型时,非增强MRA(包括TOF和PC)均不能成功处理整个流速范围,尤其在体部血管。近年发展起来的动态增强磁共振血管造影(dynamic contrast enhanced MRA DCEMRA)利用顺磁性造影剂,缩短T1时间,不受血流效应影响,从而克服了非增强MRA的缺点,有着广阔的前景。本文阐述了不同的MRA技术评价主动脉及其主要分支以及上下腔静脉和门静脉的价值和限度,并与其他微创技术包括CTA作了比较,讨论不同技术的优缺点,另外着重探讨了颈、肾、髂和肺动脉成像的过去、现状和展望。尽管该技术有局限性,如空间分辨率低,假阳性以及仅能作为诊断性检查而无法进行介入治疗,但随着MRA技术硬软件不断发展和完善以及临床研究工作的不断深入,MRA有望能逐步替代其他血管造影包括IADSA。

Magnetic resonance angiography(MRA) was widely used in head, neck and extremities since 1985 because of its non -invasion and high sensitivity Non -contrast enhanced MRA(PC and TOF) did not succeed m displaying various vascular dis-eases, especially in vessels of body. Dynam-ic contrast enhanced MRAIDCE MRA) is one of the recently fast developed techniques in MRA and shows a promising prospects in di-agnosis of some vascular diseases of aorta and major branches. With reduced T1 and without relationship with flow effect, DCE MRA overcomes limitations of non-DCE MRA. This paper evaluates the value of ap-plication of different MRA in aorta, major branches and supenor and inferior cavae and portal vein compared with other minimally in-vasive modalities such as CT angiography, mainly focus on the carotid, renal, iliac and pulmonary artery imaging. Although there are some limitations in this technique, such as the low spatial resolution, false -positive and no therapeutic inventions performed at the time of diagnosis, MRA will be progressively replacement of conventional angiography in-cluding IADSA with development of tech-nique and further clinical research.