闭气下造影剂注入法三维肺血管MRA的初步临床应用

The Preliminary Clinical Application of 3D MR Pulmonary Angiography with Breath holding and Contrast enhancing Technique

目的：介绍闭气下造影剂注入法三维肺血管ＭＲＰＡ（３ＤＭＲＰＡ）技术，认识此项技术的临床应用价值。材料与方法：临床诊断的肺癌、肺动脉血栓形成和肺动静脉瘘共１１例。ＧｄＤＴＰＡ０．２ｍｍｏｌ／ｋｇ静注后，应用高性能ＭＲ扫描系统，闭气下摄取２４层肺血管ＳＰＧＲ序列连续冠状断面像，用时２７秒。再重复同样扫描，分别获得早期相与后期相。最后，以最大强度投影法（ＭＩＰ）制成３ＤＭＲＰＡ。结果：３ＤＭＲＰＡ清楚显示正常肺血管至亚段水平。再建合成像利于观察肺血管病变的全貌及其血流动态改变，而原始图像描绘病变本身及血管腔内改变更清晰。结论：３ＤＭＲＰＡ对于肺血管疾病的诊断具有较高的临床实用价值。

Objective: To introduce the 3D MR pulmonary angiography (3D MRPA) technique, and to evaluate its clinical application.Materials and Methods:3D MRPA was performed in 11 patients with either pulmonary cancer, pulmonary thrombosis or pulmonary arteriovenous fistula. The protocol was as follows. Following intravenous bolus injection of 0.2mmol/kg Gd DTPA, coronal SPGR images of 24 slices was gained within 27 seconds. The same scanning was repeated to get the early and delayed phase images. 3D MRPA was obtained through reconstruction with MIP.Results:Normal pulmonary vessels, up to sub segmental ones, were well demonstrated on 3D MRPA. The reconstructed image was very helpful in observing the entire pathologic and hemodynamic changes of the pulmonary vessels, while the original images outline the lesion itself and intraluminal changes more clearly.Conclusion: