3.0 T颈动脉全景磁共振血管造影比较

3.0 T MR angiography of panoramic carotid artery

目的比较时间飞跃磁共振血管造影(TOF-MRA)和增强高分辨MRA(CE-MRA)、动态MRA(Dynamic,Dyn-MRA)对全景头颈部动脉粥样硬化狭窄的诊断价值。方法对31例患者行3.0 T MRA检查,均接受TOF-MRA扫描后随机接受CE-MRA和Dyn-MRA。分别对血管段显示、血管信号强度和静脉污染进行评分;以数字减影血管造影术为标准,对颈动脉分叉、颈总动脉起始部狭窄进行评价。结果与CE-MRA和Dyn-MRA比较,TOF-MRA评分4分血管段显示比例低(Z=-3.13,Z=-3.16,P<0.05);与Dyn-MRA比较,TOF-MRA评分4分血管信号强度增强比例高(Z=-2.05,P<0.05)。TOF-MRA静脉无污染,与Dyn-MRA比较,CE-MRA出现静脉污染比例高(Z=-8.62,P<0.05)。TOF-MRA诊断颈总动脉分叉处狭窄准确率高于颈总动脉起始部。结论TOF-MRA、CE-MRA和Dyn-MRA均能实现头颈部动脉全景成像;TOF-MRA可作为一线颈动脉粥样硬化筛查方法,补充CE-MRA和Dyn-MRA有助于提高颈动脉狭窄的准确性。

Objective To compare the value of TOF-MRA,high resolution CE-MRA and dynamic MRA in diagnosis of panoramic cephalo-cervical atherosclerotic stenosis.Methods Thirty-one patients with suspected cephalo-cervical atherosclerotic stenosis underwent 3.0T MRA,high resolution CE-MRA,and dynamic MRA following TOF-MRA.Vessel segment display,signal intensity,and venous pollution were scored.Stenosis in carotid bifurcation and common carotid artery was assessed according to their DSA.Results The Vessel segment display rate was lower for TOF-MRA than for CE-MRA and dynamic MRA （Z=-3.13,P＜0.01 ;Z-3.16,P＜0.05）.The signal intensity rate was higher for TOF-MRA than for dynamic MRA （Z=-2.05,P＜ 0.05）.No significant difference was found in signal intensity rate for TOF-MRA and CE-MRA （P＞0.05）.The venous pollution rate was higher for TOF-MRA and dynamic MRA than for CE-MRA （Z=-8.62,P＜0.05）.The accuracy of TOF-MRA was higher in diagnosis of stenosis in carotid artery bifurcation than in diagnosis of stenosis in the initial part of common carotid artery.Conclusion TOF-MRA,CE-MRA and dynamic MRA can achieve panoramic cephalo-cervical artery imagig.TOF-MRA can be used as a first-line screening method for carotid atherosclerosis.CE-MRA and dynamic MRA,as a complementary method,help to improve the diagnostic accuracy of carotid artery stenosis.