3D CE-MRA的临床应用

Clinical application of 3D CE-MRA

目的:探讨CE-MRA的成像技术特点和临床应用价值。方法:选取2008年5月至今50例临床明确诊断为血管病变患者的3D CE-MRA检查资料,结合其DSA、手术记录等临床资料综合分析。结果:靶血管显示优者32例,良者16例,差者2例,优良率为96%;3级以上周围小动脉显示良好,4级基本可辨;病变与血管关系、血管与周围组织关系显示良好。动脉硬化狭窄30例,动脉闭塞性脉管炎6例,动脉血栓形成4例,静脉炎5例,血管瘤3例,动脉瘤1例,1例动脉瘤漏诊;CE-MRA显示狭窄45处,其中7处DSA无狭窄而CE-MRA显示狭窄,11处CE-MRA显示狭窄程度较DSA或手术所见偏重,CE-MRA假阳性率为9%,漏诊率2%。结论:CE-MRA对大血管病变显示良好,不但能清楚显示血管本身病变、病变与血管关系、血管与周围组织关系,而且在血管侧枝循环方面显示优良,阳性率高,与DSA近似,基本可以代替诊断性DSA。

Objective：To explore the character and clinical application of CE-MRA.Methods：Clinic data of 50 cases with confirmed vascular diseases from May,2008,including 3D-CEMRA,DSA and operative record were collected.Results：It showed 32 cases with excellent results,16 with good results and 2 with poor results.The excellent and good rate was 96%.Imaging of peripheral arterioles at level 3 or above was good,while the imaging was basic discriminable at level 4.The relationship between vessels and peripheral tissues was good.There were 30 cases with arteriosclerosis,6 with thromboangitis obliterans,4 with arterial thrombus,5 with phlebitis,3 with angeioma,1 with aneurysm and 1 missing aneurysm case.CE-MRA showed 45 narrow spots,out of which 7 spots were only detected by CE-MRA,11 spots showed exaggerated imaging by CE-MRA comparing with DSA and actual situation during surgery.The false positive rate of CE-MRA was 9%,and the missing rate was 2%.Conclusions：CE-MRA can provide good imaging for macroangiopathy detection,but can′t show the vascular illness,the relationship between illness and vessels,or relationship between vessels and peripheral tissues.With good imaging of collateral circulation and high positive rate,it is alterative diagnosis method to DSA.