对比增强MR血管成像在下肢动脉疾病中的应用

Application of 3D dynamic contrast-enhanced MR angiography in artery diseases of lower extremities

目的:通过三维对比增强磁共振血管成像(3D dynamic contrast-enhanced MR angiography,3D CE-MRA)在下肢动脉狭窄或闭塞性疾病中的应用研究,探讨3.0T MR机器上3D CE-MRA的影像学特点及下肢动脉性疾病安全、有效的检查方法,从而为准确评估下肢动脉性病变提供依据。方法:回顾性分析13例临床怀疑下肢动脉狭窄或闭塞病变行3D CE-MRA检查者资料,其中9例患者在2周内同时接受数字减影血管造影(digital subtraction angiography,DSA)检查。3D CE-MRA检查所显示各动脉段包括腹主动脉下端、髂总动脉、髂外动脉、髂内动脉起始段、股动脉、腘动脉、胫前动脉、胫后动脉、腓动脉以及各侧支循环。结果:所行3D CE-MRA检查者,无造影剂过敏反应发生、无检查失败者,其中1例因左侧小腿不自主轻微抖动造成左侧胫腓段图像运动伪影。9例同时行DSA检查者,3D CE-MRA与DSA共同发现狭窄或闭塞血管27段,检查结果基本相符,其中有1例腓动脉处3D CE-MRA图像显示闭塞,而DSA显示轻度狭窄。结论:3D CE-MRA是下肢动脉病变的有效、安全的检查方法,具有较高的诊断准确度,可为临床治疗提供依据。

Objective To explore the features of 3D dynamic contrast-enhanced MR angiography（3D CE-MRA） and its application to the diagnosis of arterial diseases of the lower extremities.Methods The 3D CE-MRA data of 13 patients suspected with arteriostenosis or arterial occlusion were analyzed retrospectively,of whom,9 ones underwent DSA examinations two weeks after.The arteries showed by 3D CE-MRA included the distal abdominal aorta,common iliac artery,external iliac artery,proximal internal artery,femoral artery,popliteal artery,anterior tibial artery,posterior tibial artery,fibular artery and collateral circulations.Results All of the 13 cases were successfully examined without contrast medium allergic reactions,and1 case had motion artifact because of involuntary movement.The results by 3D CE-MRA were consistent basically with those by DSA,there were 27 sections of arteriostenosis or arterial occlusions found by arteriostenosis and DSA.One case was found with fibular arterial occlusion by 3D CE-MRA while with slight arteriostenosis.Conclusion 3D CE-MRA is an effective and safe method in detecting lower extremity artery diseases,which could provide guidance for clinical diagnosis and treatment.