MRI与CT评价上腔静脉切除置换术后患者人工血管通畅度的对比研究

Comparative study of MR imaging and CT evaluation of artificial blood vessels after superior vena cava resection and replacement surgery

目的探讨MRI在上腔静脉切除人工血管置换术后患者人工血管通畅度复查中的应用价值。方法收集2021年1月—2022年10月于四川大学华西医院行上腔静脉切除人工血管置换术后返院复查的患者42例,均施行MRI检查(MRI组)和上腔静脉CT血管成像(CTA组)。对MRI血管图像进行主观评价和客观评价。以CTA图像为参照标准,测量人工血管的血管长度,人工血管端口、中部和尾端的血管直径宽度,采用Bland-Altman图对两种扫描方法的测量值进行一致性分析。结果42例患者共置换人工血管52根。MRI组的图像质量平均评分稍低于CTA组[(4.53±0.50)分vs(4.94±0.24)分,χ^(2)=13.14,P=0.002];Bland-Altman图所得MRI和CT两种方法的差值服从正态分布,两种方法具有较好的一致性。结论与CTA相比,MRI无辐射、无需对比剂就能获得良好的人工血管成像,对人工血管是否通畅具有重要的临床应用价值。

Objective To explore the application value of magnetic resonance imaging(MRI)in assessing the patency of artificial blood vessels after superior vena cava resection and replacement surgery.Methods From January 2021 to October 2022,an analysis is conducted on 42 patients who underwent superior vena cava resection and artificial vessel replacement surgery at West China Hospital of Sichuan University.With the consent of the patients,MRI and Computed tomography angiography(CTA)of the superior vena cava are performed.Subjective and objective evaluation of MR vascular images.Using CTA images as the reference standard,measure the length of artificial blood vessels,the diameter and width of the artificial blood vessel at the port,middle and tail ends,consistency analysis of measurement values between two scanning methods using Bland Altman plots.Results 52 artificial blood vessels are replaced in 42 patients.The average image quality score of the MR group is[(4.53±0.50)]slightly lower than that of the CTA group[(4.94±0.24)].The difference between MR and CT obtain from Bland-Altman diagram follows normal distribution,and the two methods have good consistency.Conclusion MRI can obtain good artificial vascular imaging without radiation and contrast agents,which has important clinical application value for the patency of artificial blood vessel.