非对比剂增强的磁共振血管成像技术对肝静脉显示的初步评价

Non-contrast-enhanced MR Angiography for Selective Visualization of the Hepatic Vein

目的评价非对比剂增强的磁共振血管成像技术对肝静脉解剖变异的显示和诊断价值。方法用同一磁共振设备,先后对10例肝硬化患者和12例肝移植供体进行对比剂强化的磁共振血管造影(CE-MRA)和非对比剂强化的磁共振血管造影(NCE-MRA),获取肝静脉血管的影像解剖图像。由2位医师独立对每例图像质量进行技术评分,评价两种方法对于血管显示的价值。结果 NCE-MRA组和CE-MRA组中,图像质量为3分以上的分别占86.4%(19/22)和90.9%(20/22);两种方法显示22例肝静脉血管的符合率为90.9%(20/22),均没有出现假阳性病例,NCE-MRA方法出现假阴性2例。两者优良率差异无统计学意义(P>0.05),并且两位诊断医师的一致性较高,Kappa值均>0.75。结论 NCE-MRA是一种非侵入性、无需使用造影剂的磁共振血管成像技术,可以有效地用于肝静脉的评估。

Objective To evaluate the diagnostic performance of non-contrast-enhanced MR angiography（NCE-MRA） in the preoperative assessment of hepatic vein.Materials and Methods Contrast-enhanced MR angiography（CE-MRA）and NCE-MRA were performed on ten patients with hepatic cirrhosis and twelve potential living liver donors with the same 1.5T MR scanner.The anatomic angiographic images were reconstructed and reviewed by two radiologists independently.The quality of the images of hepatic vein vessels was rated with a four point scale.Results After consensus reading,19 NCE-MRA images（86.4%） and 20 CE-MRA images（90.9%） scored more than 3 point,respectively.The segmental branch vessels were visualized on MR angiography in the majority of cases.Both NCE-MRA and CE-MRA correctly characterized 20 out of 22 hepatic veins without false positive reporting.The NCE-MRA reported two false negative cases.There were no statistically significant differences between NCE-MRA and CE-MRA for the characterization of hepatic vasculature（P〉0.05）.High consistency was achieved between the two reviewers,with Kappa values over 0.75.Conclusion NCE-MRA is a non-invasive and effective method for the comprehensive assessment of hepatic vein.