移床-血管示踪MR血管成像在下肢动脉疾病中的临床应用

目的研究移床-血管示踪MRA在下肢动脉疾病中的应用价值,探讨移床技术的优势。方法对36例临床疑有下肢动脉疾病的患者行移床-血管示踪三维动态增强MRA检查,其中急性下肢动脉闭塞症5例,检查后行急诊手术,慢性下肢动脉闭塞31例,其中10例行DSA检查。15例可评价病例以DSA或手术结果作为金标准进行效果评价。结果36例病人均满意地显示了完整的下肢动脉血管。将每条下肢分为14个血管节段观察,15例可评价病例共观察420段血管节段,显示可比动脉节段102段。与DSA或手术结果比较,两者诊断符合率为93.14%(95/102),MRA诊断的敏感度为100%,特异度为100%。5例急性下肢动脉闭塞症与手术结果比较,MRA对血管闭塞长度的评价与手术无统计学差异(t=2.251,P>0.05)。结论移床-血管示踪MRA与DSA或手术比较,具有很好的一致性,能全面、准确地评价下肢动脉病变,是一种可靠的、无创的、有应用价值的检查方法。

Clinical Application of 3D Contrast-enhanced Moving-bed MRA in Arterial Diseases of Lower Extremities

Objective To study the clinical value of 3D contrast-enhanced moving-bed MRA in the diagnosis of lower extremityartery diseases and to explore the advantages of moving-bed technique. Methods 36 patients suspected of having lower extremity arterialdiseases underwent 3D contrast-enhanced moving-bed MRA.Among these patients,Five cases who were acute occlusion of lowerextremity artery were detected by emergency surgery.DSA was carried out in 10 cases who were chronic occlusive diseases of lowerextremity artery.The 15 cases diagnosis based on MRA was compared with the DSA and operation which are always the "gold standard". Results All 36 cases get clear pictures and all diseased arteries were well demonstrated.Every leg was divided into 14 vascular segments,420 arterial segments of 15 cases were demonstrated.Based on DSA and operation as standard,102 arterial segments were evaluated.The rate of accordance was 93.14%(95/102),MR angiography achieved sensitivity and specificity of 100% and 100%,respectively.5 cases compared with operation,there were no significant different between MRA and operation(t=2.251,P>0.05). Conclusion Comparedwith DSA and operation,there is excellent correlation among 3D contrast-enhanced moving-bed MRA,DSA and operation.MRA canaccurately and entirely assess occlusive disease of the arteries of the lower extremity.It is a ono-invasive,reliable and potential newtechnique.