三维增强MR血管成像对冠状动脉桥血管的评价

目的：探讨三维增强MR血管成像（3D CEMRA）评价冠状动脉搭桥术（CABG）桥血管开通状况的临床价值。方法：20例CABG患者共47支桥血管，用3D CEMRA方法进行了研究。MR检查距手术15d至16年。20例患者中14例CABG术后5个月至16年有胸痛症状再发，2例术后临床疑桥血管急性闭塞。对3D CEMRA资料进行评价，确认桥血管开通状况。对7例15支桥血管同时有3D CEMRA和X线血管造影者进行了双盲分析。结果：47支桥血管，3D CEMRA显示通畅25支，闭塞22支，闭塞率为46.8％。7例同时有3D CEMRA和X线血管造影者共15支桥血管，通畅8支，闭塞7支，二者显示完全一致。结论：3D CEMRA对桥血管的评价是可靠和准确的，可作为CABG术后患者一种无创性影像检查方法。

Three-dimensional contrast-enhanced MR angiography for evaluating patency of coronary bypass grafts

Objective To evaluate the value of three-dimensional contrast-enhanced MR angiography (3D CEMRA) for coronary artery bypass grafts (CABG) patency. Methods Twenty patients underwent CABG with 47 grafts. After surgery (15 days to 16 years) they were studied by 3D CEMRA. 14 of 20 cases had recurrence of chest pain from 5 months to 16 years after CABG surgery. Two of 20 cases were clinically suspected with acute graft thrombosis after CABG surgery. All 3D CEMRA data were evaluated for CABG patency. The results of 7 cases were compared with blinded fashion between 3D CEMRA and X-ray angiography. Results In 20 cases with 47 grafts, 3D CEMRA showed patency in 25 grafts and occlusion in 22. The graft occlusion rate was 46.8%. 15 grafts in 7 cases were studied by both 3D CEMRA and X-ray angiography. These two imaging modalities revealed patency in 8 grafts and occlusion in 7, and the result was in complete accordance with each other. Conclusion 3D CEMRA is reliable and accurate in evaluating the graft patency. It is a potential noninvasive imaging examination for assessing graft patency in patients who have undergone CABG surgery.