单次屏气三维动态增强磁共振门静脉成像技术及初步应用体会

Single breath - hold three - dimensional magnetic resonance contrast - enhanced portography and preliminary application

目的 探讨单次屏气三维动态增强磁共振门静脉成像(3D DCE MRP)技术的可靠性及临床应用价值。方法 对40例受检者行常规轴位T1W,T2W成像后,进行冠状位3D DCE MRP,连续扫描3组数据,对感兴趣区血管的原始图像用最大强度投影法重建。评价图像质量,分析门静脉、脾静脉、肠系膜上静脉显示情况和有无侧支循环形成。扫描前经静脉快速注射钆喷酸葡胺20～30ml。结果 39例门静脉图像质量达到诊断要求,1例血管图像模糊。20例无门静脉高压症患者的肠系膜上静脉、脾静脉、门静脉主干及其肝内3～5级分支均显示良好,门静脉高压症可出现肠系膜上静脉及门静脉增宽、门静脉栓塞、肝内门静脉分支级数减少、脾静脉迂曲增粗以及侧支血管形成。结论3D DCE MRP是了解门静脉系统结构的可靠方法,可用于肝脏多种疾病的诊断和疗效评价。

Objective To evaluate the method of the single breath - hold three - dimensional dynamic contrast - enhanced magnetic resonance portography (3D DCE MRP) and its preliminary clinical application. Methods Following T1WI and T2WI, 3D DCE MRP was performed in 40 subjectives. After a bolus injection of Gd - DTPA 20 - 30ml by hand intravenously, consecutive 3 groups of data acquisition was done during 3 respective breath - hold period.The portal veins and other vessels in the region of interest in source images were reconstructed with maximum intensity projection (MIP) technique.The quality of all images was assessed and the patency of portal vein, splenetic vein, superior mesenteric vein as well as collateral vessels was analyzed.Results Except one case, the image quality in 39 cases was satisfactory.The vasculature of portal vein trunk and its 3 - 5 grade intrahepatic branches, splenetic vein, superior mesenteric vein was well visualized in 20 cases without portal hypertension.Portal hypertension may appear as enlarged superior mesenteric vein and portal vein, thrombotic occlusion of the portal trunk, diminished intrahepatic branches of the portal vein, tortous and enlarged splenetic vein, and the formation of the collateral vessels. Conclusion 3D DCE MRP was a effective method in evaluating portal venous system, it could be used to diagnose liver diseases and assess treatment.