三维增强磁共振肺动脉血管造影诊断肺动脉血栓栓塞

目的 探讨三维增强ＭＲ肺动脉血管造影（３Ｄ ｃｏｎｔｒａｓｔ－ｅｎｈａｎｃｅｄ ＭＲ ｐｕｌｍｏｎａｒｙ ａｎｇｉｏｇｒａｐｈｙ，３Ｄ ＣＥＭＲＰＡ）诊断肺动脉血栓栓塞的价值。方法 肺动脉栓塞患者１２例，共行１７次３Ｄ ＣＥＭＲＰＡ，其中４例５次于３Ｄ ＣＥＭＲＰＡ当天进行了选择性肺动脉ＤＳＡ。静脉注射钆喷替酸葡甲胺０．２ｍｍｏｌ／ｋｇ后，屏气获得２４层肺血管连续冠状面像，以最大强度投影法（ＭＩＰ

Pulmonary thromboembolism: diagnosis with contrast-enhanced three-dimensional MR pulmonary angiography

Objective To evaluate the ability of contrast enhanced three dimensional MR pulmonary angiography (3D CEMRPA) in the diagnosis of pulmonary thromboembolism Methods Twelve patients with pulmonary thromboembolism were examined seventeen times by 3D CEMRPA, and were examined 5 times by DSA at the same day in 4 cases Following intravenous bolus injection of Gd DTPA 0 2 mmol/kg, coronal SPGR images consisting of 24 slices were acquired 3D CEMRPA was reconstructed by using maximum intensity projection technique based on these original images Results 3D CEMRPA findings of pulmonary thromboembolism included stenosis, complete obstruction, post stenotic dilatation of pulmonary arteries Comparing the results of 3D CEMRPA with thase of DSA pulmonary angiography, both of them have the same diagnostic rate for the main vessel abnormalities at lobar level, even one small defect in right inferior pulmonary artery was shown on original 3D CEMRPA image but not on DSA However, 3D CEMRPA wasn't as good as DSA in displaying segmental vessel abnormalities Conclusion 3D CEMRPA can be used as an effective diagnostic method for the central pulmonary thromboembolism