3.0T高时间分辨率对比增强MRA颅内血管成像

Clinical application of time-resolved contrast-enhanced 3D MRA of intracranial vasculature with 3.0T MR scanner

目的:评价3.0T高时间分辨率对比增强磁共振血管成像(TR 3DCE-MRA)在颅内血管成像的技术可行性和临床应用价值。方法:经医院伦理委员会批准,回顾性搜集21例患者,采用3.0T磁共振,首先行常规序列T1WI、T2WI和TOF MRA扫描,然后在确定病变处用TR 3DCE-MRA即快速小角度激发梯度回波序列(3DFLASH)。所有病例在检查后1～3d行高分辨率增强MRA(HR CE-MRA),测量动脉的信噪比和对比噪声比,由2位影像专家对TR CE-MRA和HR CE-MRA图像质量进行评价,分别对图像伪影、静脉污染、脑动脉显示效果进行评分。评分结果采用SPSS 13.0进行统计学分析,差异具有统计学意义(P<0.05)。结果:21例患者中动脉瘤3例,动静脉畸形7例,烟雾病2例,动脉狭窄9例。图像SNR和CNR测量均值分别为237±89和213±94,Wilcoxon test检验结果Z=-3.160,P=0.002<0.05,静脉污染组Z=-4.298,P=0.001<0.01,血管显示组Z=-4.491,P=0.001<0.01,差异有明显统计学意义。结论:TRCE-MRA比HR CE-MRA具有严重伪影少,没有静脉污染,良好的血管对比,能够同时评价动脉血管和静脉血管,将是颅内血管疾病的首选。

Objective：To evaluate the feasibility and clinical value of time resolved contrast enhanced three-dimension- al magnetic resonance （MR） angiography （TR 3D CE MRA） with 3.0T MR scanner of intracranial vasculature. Methods： Approved by the ethic committee of the hospital,21 patients underwent routine TlWI,T2WI and TOF MRA with a 3.0T MR scanner were retrospectively studied. After the lesion was revealed, all patients underwent TR 3D CE MRA with 3D FLASH sequence, then, single phase high spatial resolution contrast-enhanced three-dimensional magnetic resonance angi ography （HR CE 3D MRA） 1-3 days after was performed. The arterial signal-to-noise ratio （SNR） and contrast to noise ratio （CNR） were measured and the image quality were evaluated,as well as the image artifact,venous contamination and the contrast effect of cerebral arteries displayed on TR 3D CE MRA were compared to that of HR CE-MRA and scored by two radiologists. The results were analyzed with Wilconxon test using SPSSl3.0 software. Results：Of the 21 patients, there were aneurysm （n=3）,arteriovenous malformation （n--7）,moyamoya disease （n 2） and arterial stenosis （n=9）. The mean value of SNR and CNR was 237q-89 and 213~94,respectively. The result of Wilcoxon test for the Group of artifact wereZ 3.160,P=0.002〈0.05;for Group of venous contamination were Z 4.298,P 0.001〈0.01,and for the contrast effect of cerebral arteries were Z=- 4. 491 ,P 0. 001 d0.01, with significant statistical differences. Conclusion： TR 3D CF MRA showed lesser severe artifacts,lesser venous contamination, better contrast enhancement of cerebral vascu lature,and ewduation of arterial and venous disease simultaneously was allowed,which could be used as the first choice for the diagnosis of intracranial vascular disease.