高时间分辨率三维动态增强磁共振血管造影与CTA在下肢软组织肿块血管评估中的比较

A comparative study of dynamic time-resolved MR angiography and CTA in evaluating lower extremity tumors

目的：比较高时间分辨率动态增强磁共振血管造影（TWIST-MRA）与CTA在下肢软组织肿块术前血管评估中的价值。方法：62例临床疑似下肢软组织肿块的患者（男36例,女26例,年龄18~80岁,平均40.9岁）同时行下肢TWIST-MRA和CTA检查;由2名具有10年以上阅片经验的影像医师对两者显示供血动脉数量和动静脉畸形的能力进行评判、比较。结果：62例患者中TWIST-MRA显示主要供血动脉的（股浅动脉、股深动脉等）一级分支数量为（1.92±1.66）,CTA显示一级分支数量为（1.50±1.45）;由于统计数据为非正态分布,故采用配对Wilcoxon秩和检验法,TWISTMRA显示肿瘤主要供血动脉（股浅动脉、股深动脉等）一级分支数等于CTA者38例;多于CTA者21例;少于CTA者3例,两者具有显著统计学差异（｜Z｜=3.368,P=0.001）。62例患者中TWIST-MRA和CTA显示动静脉瘘分别为34例（34/62）和15例（15/62）,两者差异具有统计学意义（χ2=12.181,P〈0.001）。结论：TWIST-MRA检测供血动脉和动静脉瘘的能力优于CTA。

Objective：To compare the diagnostic value of dynamic time-resolved MR angiography（TWIST）and CT angiography（CTA）in preoperative evaluation of lower extremity tumors.Methods：62consecutive patients with clinically suspected lower extremity soft tissue masses underwent TWIST MRA and CTA.The ability of identifying feeding artery and arteriovenous fistula was compared between the two examine methods by two radiologists with 10-year experience.Wilcoxon rank and test was used due to the non-normal distribution of statistical data.Results：The number of primary branch of tumor feeding artery（superficial and deep femoral arteries,etc）in TWIST-MRA group equal to that in the CTA group was38 cases,more than that in CTA group was 21 cases,and less than that in CTA group was 3cases.The numbers of arteriovenous fistula found in MRA and CTA groups were 34 cases and 15 cases respectivey in 62 cases of patients.So,there were statistical important differences between MRA and CTA in identifying the vascular changes（P 〈0.05）.Conclusion：TWIST-MRA is superior to CTA in detecting feeding artery and arteriovenous fistula of lower extremity tumors.