Le Blanche A F, Rossert J, Wassef M, Lévy B, Bigot J M, Boudghene F
Department of Radiology, Tenon University Hospital, 4 rue de la Chine, F-75970 Paris Cedex 20, France.
Cardiovasc Intervent Radiol. 2000 Sep-Oct;23(5):368-74. doi: 10.1007/s002700010059.
To assess in vivo 1) MR-guided percutaneous transluminal renal angioplasty (PTRA) in experimental bilateral rabbit renal artery stenosis (RAS); 2) postprocedural follow-up by gadolinium-enhanced MR angiography versus histomorphometry.
Fifteen male NZW rabbits of mean weight 4.0 kg (range 3.5-4.2 kg) underwent bilateral RAS induction by combined overdilation-deendothelialization with a gadolinium-filled balloon, passively MR-guided by the artifact of a 0.014-inch guidewire. After 4 weeks the rabbits were randomized into two groups: group A (n = 8) underwent right-sided PTRA for treatment of RAS, group B (n = 7) underwent left-sided PTRA. After another 4 weeks the rabbits were killed to assess by histomorphometry recurrent stenosis and contralateral induction injury stenosis lesions. Each step was preceded by gadolinium-enhanced three-dimensional MR angiography, and the cortex-to-aorta (C/A) signal intensity ratio was calculated.
RAS induction was successful in all cases. Fourteen arteries developed restenosis and 13 only initial stenosis. MR-guided PTRAs were feasible in 22 arteries (73%). For a successful catheterization of the ostium (20 arteries, 66% success rate), 10-25 steps were required. Five to eight steps were required for balloon localization and inflation for each PTRA. The restenosis effect was reflected by a 16% (12%-27%) decrease in C/A values on MR angiograms (p < 0.05).
MR guidance and MR angiography represent a feasible, less invasive alternative for performing and assessing experimental PTRA in RAS.
评估在实验性双侧兔肾动脉狭窄（RAS）中进行1）磁共振引导下经皮腔内肾血管成形术（PTRA）；2）钆增强磁共振血管造影与组织形态计量学的术后随访。
15只平均体重4.0千克（范围3.5 - 4.2千克）的雄性新西兰白兔通过用充满钆的球囊进行联合过度扩张 - 去内皮化诱导双侧RAS，由0.014英寸导丝的伪影被动地进行磁共振引导。4周后，将兔子随机分为两组：A组（n = 8）接受右侧PTRA治疗RAS，B组（n = 7）接受左侧PTRA。再过4周后，将兔子处死，通过组织形态计量学评估再狭窄和对侧诱导损伤狭窄病变。每一步之前都进行钆增强三维磁共振血管造影，并计算皮质与主动脉（C/A）信号强度比。
所有病例中RAS诱导均成功。14条动脉发生再狭窄，13条仅为初始狭窄。22条动脉（73%）的磁共振引导下PTRA可行。对于成功插入开口（20条动脉，成功率66%），需要10 - 25步。每次PTRA的球囊定位和充盈需要5 - 8步。再狭窄效应通过磁共振血管造影上C/A值降低16%（12% - 27%）得以体现（p < 0.05）。
磁共振引导和磁共振血管造影是在RAS中进行和评估实验性PTRA的一种可行、侵入性较小的替代方法。
