三段移床三维增强MRA在腹盆及下肢血管病变中的应用

目的　探讨三段移床三维增强MRA 1次全程显示腹盆及下肢血管树的技术及其在血管病变诊断中的作用。方法　 12例腹盆及下肢血管病变的患者 ,男 8例 ,女 4例。 10例同时做了动脉和静脉成像 ,其中动脉血栓形成 5例 ,动脉硬化性闭塞性脉管炎 6例 ,静脉血栓形成 7例 ,下肢静脉炎 3例。其中 5例经DSA证实 ,5例手术证实。扫描序列采用三维快速SPGR序列 ,移床三段扫描。结果　靶血管显示优 9例 ,良 3例。有手术或DSA结果 10例中 ,共有病变段 3 4段 ,其MRA诊断与DSA或手术符合率为 85 .3 %。结论　移床三维增强MRA能使腹主动脉及两侧髂动脉分叉到小腿动脉全程显影 ,还可显示静脉。侧枝循环情况显示优于DSA ,是一种前途广阔的简便的血管检查新方法。

The Use of Three-section Bed-moving 3D Dynamic Contrast-enhanced MRA in Vascular Disease of the Abdomen, Pelvis and Lower Extremity

Objective To assess the value of three-section bed-moving 3D dynamic contrast-enhanced MRA (3D DCE) in showing the vascular tree of abdomen, pelvis and lower extremity at one go-off for diagnosis of vascular diseases.Methods Three-dimension dynamic contrast-enhanced MRA was performed in 12 patients (male, 8; female, 4) suspected of iliac and lower extremity vascular disease. Both arterial and venous imagings were underwent in 10 cases. Among them, there were 5 cases with arterial thrombosis, 6 with atherosclerotic occlusion angitis, 7 with venous thrombosis and 3 with lower extremity phlebitis. Five cases were confirmed by DSA and 5 by operation. 3D FSPGR and three-section bed-moving 3D DCE were applied.Results Based on the quality of target vessel images, 9 cases were judged as excellent and 3 were good. Thirty-four segments disordered vessel were proved by DSA or operation. Among them,29 segments were detected by MRA, with a coincidence rate of 85.3%.Conclusion Three-section bed-moving 3D DCE MRA could depict all round vascular from abdominal aorta and fork of iliac arteries to the foot arteries. At the same time, veins are also showed clearly. Moreover, the collateral circulations are demonstrated better by this method than by DSA. So this is a new simple and promising method for vessel imaging.