主动脉夹层几种磁共振影像的评价和比较

目的：评价和比较ＭＲＩＳＥ常规序列、电影（ｃｉｎｅ）ＭＲＩ及ＭＲ血管造影（ＭＲＡ）对主动脉夹层的诊断价值。材料和方法：对２５例主动脉夹层进行了３１人次ＭＲ检查。其中包括胸腹主动脉ＳＥ序列３１人次，胸主动脉ｃｉｎｅＭＲＩ２３人次及腹主动脉二维时间飞跃（２ＤＴＯＦ）ＭＲＡ２１人次。将ｃｉｎｅＭＲＩ及ＭＲＡ分别与其相应ＳＥ序列ＭＲ表现进行比较。结果：胸主动脉ｃｉｎｅＭＲＩ２３例与相应ＳＥ序列比较，两者所有病例均显示内膜片及真假两腔，但显示破口分别为１４和９例。显示头臂血管受累分别为７和２条。腹主动脉ＭＲＡ２１例与相应ＳＥ序列比较，两者均显示内膜片和真假两腔，但显示破口或再破口者分别为４和２例，腹主动脉分支血管受累分别为３９和１４条。结论：ＭＲ是诊断主动脉夹层的最佳影像学方法之一。在常规ＳＥ序列基础上，辅以ｃｉｎｅＭＲＩ和ＭＲＡ技术将大大提高ＭＲ总体观察夹层范围、内膜破口以及分支受累的能力，给临床提供更多的信息。

MRI of aortic dissections: evaluation and comparison of MRI, cine MRI and MRA

Purpose: To evaluate and compare the value of spin echo (SE), cine MRI and MRA in diagnosing aortic dissections. Materials and methods: Twenty five patients underwent 31 MR exa minations: including 31 examinations of SE covering thoracic and abdominal aorta, 23 examinations of cine MRI covering thoracic aorta and 21 examinations of 2D TOF MRA covering abdominal aorta. The appearances of cine MRI and SE as well as those of MRA and SE were compared with each other respectively. Results: On comparing the appearances of cine MRI and SE in thoracic dissections of 23 cases, all cases of both groups showed intimal flap and double lumen. But the demonstrations of entry tears were 14 and 9 among 23 cases respectively. The involvements of brachiocephalic arteries were 7 and 2 among all brachiocephalic arteries respectively. On comparing the appearances of MRA and SE in abdominal dissections of 21 cases, all the cases of both groups also showed intimal flap and double lumen. But the demonstrations of entry tears and reentry tears were 4 and 2 among 21 cases respectively. The involvements of abdominal aortic branches were 39 and 14 among all abdominal aortic branches respectively. Conclusion: MR is one of the optimal imaging techniques in diagnosing aortic dissections. Conventional SE associated with cine MRI and MRA will greatly increase the capabilities of MR in observing the extent of dissections and entry tears and involvements of vessel branches as a whole and will provide more informations for clinic doctors.