3D DCE MRA肾静脉成像及其临床应用价值

目的:探讨三维对比增强磁共振血管成像(3D DCE MRA)行肾静脉成像及其诊断肾静脉病变的价值。材料和方法:肾静脉病变、解剖变异患者29例,常规腹部MR扫描(包括横断面T1WI、T2WI,冠状面T2WI),三维容积超快速多期动态增强扫描序列(Propeller LAVA)行冠状面血管成像,采用容积再现(VR)、多平面重建(MPR)及最大强度投影(MIP)进行肾静脉重建。结果:肾癌肾静脉瘤栓5例,表现为条状或结节状充盈缺损;门静脉高压肾静脉侧支循环10例:与脾静脉交通7例,与胃底曲张静脉团交通1例,门脉高压脾-肾静脉交通并左侧性腺静脉曲张2例;左肾静脉压迫综合征2例,其中1例与腰静脉丛交通;性腺静脉曲张14例,右侧2例,左侧13例,其中肝癌下腔静脉阻塞综合征并双侧性腺静脉扩张1例,曲张的性腺静脉与左肾内静脉分支相连2例;解剖变异1例。结论:3DDCEMRA能清楚显示肾静脉及其病变,能为肾静脉相关疾病的诊断及制定手术方案提供依据。

3D DCE MRA of the Renal Vein Imaging and Clinical Application

Purpose:To explore the value of 3-dimensional dynamic contrast enhanced MRA(3D DCE MRA) in the renal vein imaging and the urinary tract disease diagnosing.Materials and Methods:Twenty-nine patients with renal vein diseases or anatomy variations underwent routine MRI(including axial T1WI,T2WI,and coronal T2WI) and propeller 3D LAVA coronal scan for vessels imaging,then post processed images of VR,MPR,and MIP to review renal veins.Results:In total of 29 patients,5 had renal vein tumor thrombus due to renal carcinoma appeared as filling defect,10 had renal vein collateral circulation caused by portal hypertension,14 had gonadal varicosity.Conclusion:3D DCE MRA can show renal vein and its related diseases clearly,which may help for the diagnosis and surgical plan.