先天性心脏病复杂畸形的增强磁共振血管造影与X线心血管造影的影像对比研究

目的 评估动态增强磁共振血管造影（DCE－MRA）诊断先天性心脏病（先）复杂畸形的临床价值。材料与方法 ２８例先心复杂畸形和大血管形患者术同时接受ＤＣＥ－ＭＲＡ、平发和／或电影以及Ｘ线心血管造影（ＣＡＧ）检查，对ＤＣＥ－ＭＡＲ原始图像进行最大信号强度投影法（ＭＩＰ）和多轴位重建法（ＭＰＲ）重建处理，以手术病理发现为基础，将ＭＲ图像与ＣＡＧ进行诊断价值对比，并进行统计学处理。结果 ＤＤＣＥ－ＭＲＡ所获取的图像对比鲜明，靶血管轮廓清晰，其 显示心脏及大血管的形态和空间分布的能力与ＣＡＧ具有很好的一致性，相关系数r=0.88。２种检查方法均能良好地显示心脏、大血管病变，DCE-MRA发现变病能力略优于ＣＡＧ，两者显示病变符合率达９３％。结论 ＤＣＥ－ＭＲＡ检查安全、无创，与ＣＡＧ一样能显示复杂的、多部位的病变，是一种非常有价值的影像学检查手段，有望部分替代常规血管造影而成为一种新的检查方法。

A Comparative Study of Contrast-enhanced MRA and Conventional Angiography in Complex Congenital Heart Disease

Objective To evaluate dynamic contrast enhanced magnetic resonance angiography (MRA) in diagnosing congenital heart diseases. Materials and Methods Contrast enhanced MRA, plain MRI and/or MR cine, and conventional angiography were performed in 28 patients with complex congenital heart diseases. All raw data of dynamic contrast enhanced MRA were reconstructed with MIP and MPR, the images were compared with that of conventional angiographs, and the results were statistically analyzed.Results Dynamic contrast enhanced MRA produced images with best contrast, and well displayed the outline of the target vessels. Contrast enhanced MRA and conventional angiography were excellently in agreement in demonstrating the heart shape and vascular outlines (r=0.88). Dynamic contrast enhanced MRA was a little bit better than conventional angiography in detecting the pathological changes. Conclusion Being a safe and noninvasive method, dynamic contrast enhanced MRA, like conventional angiography, can well display the complex pathological changes of congenital heart abnormalities. It is a valuable imaging technique, and, hopefully, may replace conventional angiography in certain degree.