下肢血管MRA的临床应用和评价

目的 :探讨MRA对下肢血管性病变的临床应用价值。方法 :12 0例资料完整的下肢血管性病变行 2DTOTMRA检查 ,其中 45例同时行动态增强MRA(DCEMRA)。 12 0例中 2 1例与血管造影对照 ,35例与手术对照 ,6 6例与超声检查对照研究。结果 :MRA与血管造影符合率 92 .2 6 % (15 5 /16 8) ,与手术符合率 93.0 2 % (88/94) ,与超声符合率 93.10 % (189/2 0 3)。结论 :2DTOTMRA能清楚显示下肢动脉狭窄、闭塞、动脉瘤、血管瘤、动 -静脉畸形 ,以及下肢深静脉狭窄和血栓形成。DCEMRA能进一步显示病变范围、术后吻合口、移植血管和动静脉畸形的供血、引流血管。MRA和血管造影、手术、超声对照符合率高(>90 % ) ,当MRA与超声结果一致时 ,基本上可取代创伤性的血管造影。

Clinical Application and Evaluation of MR Angiography for the Blood Vessels of Lower Extremity

Objective: To evaluate the effectiveness of MRA in the diagnosis of the vascular disease of the lower extremity. Methods: In 120 cases with clinical diagnosis of vascular disease of the lower extremity, 2D TOF MRA were performed, among them 45 cases DCE MRA were also done. Among these patients, other examinations such as ultrasound were performed in 66 cases and angiography in 21 cases and operation was performed in 33 cases. Results: When MRA was compared with angiography, the accordance rate was 92.26%(155/168), and it compared with ultrasound, the accordance rate was 93.10% (189/203), and it compared with operation, the accordance rate was 93.62% (88/94). Conclusion: 2D TOF MRA can show clearly the stenosis or occlusion, aneurysm, angioma, arteriovenous malformation, deep venous thrombosis or stenosis, whereas DCE MRA can show more clearly the aneurysm, angioma, supplying or drainage blood vessel of arteriovenous malformation, site of anastomosis and transplanted arteries after bypass operation in the lower extremity. Excellent correlation was noticed among MRA, angiography, operation and ultrasound (>90%). When MRA is accordant with ultrasound, it can basically substitute angiography, which is an invasive procedure.