3D SSFP成像技术在先天性心脏病Fontan术后中的应用

Application of 3D SSFP to Patients with Congenital Heart Disease After Fontan Operation

目的探讨三维稳态自由进动成像技术在先天心脏病Fontan术后随访中的价值和技术要点。方法 3D SSFP技术应用于30例(7.87±2.52岁)先天性心脏病Fontan术后随访中,同时进行对比剂血管增强造影序列扫描,然后对两者图像质量进行比较分析。结果 21例收缩末期采集图像,心电触发延迟时205~245 ms,平均(226.57±12.50)ms,采集窗宽48~65 ms;9例舒张中晚期采集图像,心电触发延迟时间565~680 ms,平均(646.11±34.17)ms,采集窗宽85~120 ms。膈肌导航窗宽4~8 mm。上腔静脉与肺动脉吻合口清晰度3D SSFP(4.83±0.38)高于CE-MRA(3.93±0.58),差异有统计学意义(P<0.001)。下腔静脉与肺动脉吻合口清晰度3D SSFP(4.93±0.25)优于CE-MRA(3.77±0.57),差异有统计学意义(P<0.001)。结论 3D SSFP在Fontan术后随访中,可以减少造影剂的应用,清晰显示腔静脉与肺动脉吻合口、肺动脉发育情况,是Fontan术后很好的随访手段。

Objective To explore the value and technical key points of three dimensional steady state free precession sequence(SSFP) in follow-up after Fontan operation for congenital heart disease. Methods 3D SSFP and contrast enhanced magnetic resonance angiography(CE-MRA) were performed on 30 patients(7.87±2.52 years old) with congenital heart disease after Fontan operation. The image qualities of 3D SSFP and CE-MRA were compared. Results Images of 21 cases were acquired in systole, and ECG trigger delay time was from 205 ms to 245 ms(226.57±12.50 ms)with acquisition window from 48 to 65 ms.Images of the other 9 cases were acquired in diastole, and ECG trigger delay time was from 565 ms to 680 ms(646.11±34.17 ms)with acquisition window from 85 ms to 120 ms. The image quality of 3D SSFP(4.83±0.38) was significantly(P<0.001) greater than that of CE-MRA(3.93±0.58) for the superior vena cava-pulmonary artery the anastomosis. The image quality of 3D SSFP(4.93±0.25) was also significantly(P<0.001) greater than that of CE-MRA(3.77±0.57) for the inferior vena cava-pulmonary artery anastomosis. Conclusion 3D SSFP can be considered as a useful technique in the follow-up of patients after Fontan operation,which could provide images of better quality for the vena cava-pulmonary artery anastomosis, and the development of the pulmonary arteries, and even could decrease the application of contrast.