小腿加压3.0 T MRA评估糖尿病下肢血管病变的价值探讨

Evaluation of diabetic peripheral arterial disease in lower limb by using 3.0 T contrast-enhanced MR angiography with simultaneous calf compression

目的以DSA为金标准评价小腿加压法3.0 T增强磁共振血管成像(CE-MRA)在糖尿病下肢血管病变的应用价值。方法对61例2型糖尿病合并下肢血管病变患者进行双下肢MRA检查,患者平均病程(11.6±6.0)年。使用3.0 T CE-MRA,其中小腿袖带加压后成像者(即加压组)31例,常规成像者30例(即常规组),所有患者1周内行DSA检查。2名放射专家分别评估获得的MRA图像,并对两组结果进行比较。结果 在小腿和足部的图像质量上,加压组优于常规组(P<0.05)。在显示小腿部位>50%狭窄或闭塞病变上,加压组优于常规组(P<0.05),同时小腿加压后可以明显抑制静脉重叠(P<0.05)。结论小腿加压3.0 T CE-MRA简单实用,可以提高糖尿病患者下肢病变血管的图像质量和诊断准确性。

Objective To determine the value of 3.0 T contrast-enhanced MR angiography（CE-MRA）with simultaneous calf compression in demonstrating and diagnosing diabetic peripheral vascular disease.Methods Sixty-one patients with type 2 diabetes mellitus complicating vascular disease of lower limb were enrolled in this study,The patients included 37 males and 24 females with a mean age of（70 ± 7.65）years.The mean duration of disease was（11.6 ± 6.0）years.The patients were randomly divided into compression group（n = 31）and conventional group（n = 30）.CE-MRA with a 3.0 T MR unit was performed in all patients.During CE-MRA,calf compression with a cuff was simultaneously applied to patients of compression group.DSA,which was regarded as gold standard,was conducted within one week after the procedure.The quality of MRA images was separately evaluated by two radiologists,the results were compared between two groups.Results Taking DSA findings as reference,the image quality of calf and foot in compression group was much better than that in conventional group（P 〈0.05）.Moreover,for the demonstration of 50% arterial stenosis or occlusion of leg the image in compression group was also better than that in conventional group（P 〈0.05）.CE-MRA with simultaneous calf compression could significantly eliminate the overlapping venous shadow（P 〈0.05）.Conclusion The 3.0 T CE-MRA with simultaneous calf compression is a simple and practical technique,it can markedly improve the image quality as well as the diagnostic accuracy of peripheral vascular disease of lower limb in diabetic patients.