磁共振等体素容积快速自旋回波上肢血管通路成像可行性研究

Magnetic Resonance Volumetric Isotropic TSE Acquisition Imaging of Arteriovenous Fistulas in Patients with Renal Failure

目的探讨运用MR等体素容积快速自旋回波(VISTA)技术对上肢自体动静脉瘘(AVF)成像及评估的可行性。方法搜集36例上肢AVF患者分别进行VISTA和时间飞跃法(TOF)扫描,对其中10例患者进行对比增强磁共振血管成像(CE-MRA)。评估三个序列图像上AVF的图像质量、管腔信号均匀度(CV)、组织对比度(MVR),测量AVF管壁厚度、管径、吻合角等并与临床指标做相关分析。结果 VISTA显示的AVF图像质量明显优于TOF(P<0.05)、与CE-MRA无统计学差异(P>0.05);且其CV和MVR均优于TOF与CE-MRA(P均<0.05);VISTA显示的AVF管壁厚度和静动脉管径比均与透析时间中等相关(r分别为0.484和0.509,P均<0.05),并且可以清晰显示血管迂曲、血栓及血管瘤。结论 VISTA序列用于AVF成像是可行的,并可准确评估AVF形态学改变。

Objective To explore the feasibility of using MR and other voxel volume fast spin echo technique(VISTA)to image and evaluate autologous arteriovenous fistula(AVF)of upper limbs.Methods Sixty-six patients with upper extremity AVF were scanned with VISTA and TOF,and 10 patients were subjected to enhanced MRA(CE-MRA)imaging.The image quality,lumen signal uniformity(CV),tissue contrast(MVR)of AVF on three sequence images were evaluated,and AVF wall thickness,tube diameter,and anastomosis angle were measured and correlated with clinical indicators.Results The quality of AVF images displayed by VISTA was significantly better than that of TOF(P<0.05),and there was no significant difference with CE-MRA(P>0.05).The uniformity of lumen signal and tissue contrast were better than TOF and CE-MRA.P<0.05);the AVF wall thickness and the ratio of the arteriolar diameter to the VISTA showed moderate correlation with dialysis time(r=0.484 and 0.509,respectively,P<0.05),and clearly showed vascular tortuosity,thrombosis and hemangioma.Conclusion The VISTA sequence is feasible for AVF imaging and can accurately assess the morphological changes of AVF.