三维增强磁共振肺动脉血管造影诊断急性肺栓塞的实验研究

Diagnosis of acute pulmonary embolism with contrast enhanced MR angiography: an experimental study

目的 探讨钆喷替酸葡甲胺 (Gd DTPA)三维增强磁共振肺动脉血管造影成像 (3DCEMRPA)在急性肺栓塞 (pulmonaryembolism ,PE)中的诊断价值。方法 对 17只自体血栓引发的犬急性肺栓塞模型 ,利用 3D快速扰相梯度回波序列 (FSPGR)行 3DCEMRPA检查和X线肺动脉血管造影(X raypulmonaryangiography ,XPA)检查 ,并与病理解剖对照。结果 病理解剖共 32 7个肺动脉节段 ,发现 41个栓子。肺栓塞 3DCEMRPA的表现为 :血管完全闭塞 30支、肺实质灌注缺损 2 3支、肺动脉部分充盈缺损 3支和中心性充盈缺损 1支。 3DCEMRPA诊断肺栓塞的敏感性为 82 9% ,特异性为98 2 % ;而XPA的敏感性为 75 6 % ,特异性为 97 9%。结论 3DCEMRPA诊断肺栓塞有较高的敏感性和特异性 。

Objective To assess the diagnostic value of three dimensional contrast enhanced magnetic resonance pulmonary angiography (3D CEMRPA) with dadolinium DTPA in acute pulmonary embolism (PE) Methods Seventeen dogs with acute pulmonary embolism induced by autologous blood clots were examined with 3D CEMRPA using a fast spoiled gradient echo technique and with X ray pulmonary angiography (XPA) The findings were compared with pathological dissection Results The 3D CEMRPA signs of acute PE were: total vessel occlusion(30/41), pulmonary perfusion defect (23/41), partial filling defect (3/41) and central filling defect (1/41) in the pulmonary artery The sensitivity of 3D CEMRPA was 82 9%, specificity 98 2%, whereas the sensitivity and specificity of XPA was 75 6%, 97 9%, respectively Conclusion 3D CEMRPA for the detection of acute PE demonstrates high sensitivity and specificity, but the technique needs to be confirmed by further clinical trials