三维增强磁共振血管成像在糖尿病足病外周动脉病变中的应用

目的:探讨3D CE MRA在糖尿病足病外周动脉病变检查中的成像方法及应用价值。方法:对17例临床怀疑外周动脉病变的糖尿病足病患者,运用MR 3D FLASH自减影序列行CE MRA检查,检查范围自腹主动脉下段至足背动脉,对靶血管作最大强度投影(MIP)重组。另对其中4例小腿及足部动脉单独行二次增强扫描(Gd-DTPA 15ml,2.5ml/s)。对外周动脉进行观察,分析其狭窄情况并分级。结果:所有患者显示目标动脉基本满意,血管解剖形态较清晰,病变显示较明确。正常或轻度狭窄169个节段,中度狭窄94个节段,重度狭窄45个节段,闭塞49个节段。结论:3D CEMRA在糖尿病足病外周动脉病变检查中具有重要意义,但尚有一定局限性。

Three-Dimensional CE-MRA Study of Peripheral Arterial Disease in Diabetic Patients with Foot Problems

Objective:To study the method and diagnostic value of 3D CE-MRA of peripheral arterial disease in diabetic patients with foot problems.(Methods:)Seventeen diabetic cases suspected of peripheral arterial disease underwent CE-MRA using 3D FLASH automatic subtraction sequence.CE MRA was performed with a FOV from the distal abdominal aorta to the dorsal artery of foot.Postprocessing techniques including 3D MIP reconstruction of the subtraction images and integration of the anteroposterior MIP images.Lower leg and pedal arteries of 4 in the 17 cases accepted additional enhancing re-scan(Gd-DTPA 15ml,2.5ml/s).Peripheral artery tree was studied to assess stenosis grading.Results:In 17 cases,all target arteries were well demonstrated and the diagnosis was definite.In a total of 357 arterial segments,normal or mild stenosis were found in 169 segments,moderate stenosis in 94,severe stenosis in 45 and occlusion in 49 segments.Conclusion:3D CE-MRA was a promising and valuable method for the examination of peripheral arterial disease in diabetic patients with foot problems,however,some limitations still existed.