Wetzel S G, Haselhorst R, Bilecen D, Lyrer P A, Seifritz E, Bongartz G, Radue E W, Scheffler K
Section of Neuroradiology, University Hospitals, Kantonsspital Basel, Switzerland.
Eur Radiol. 2001;11(2):295-302. doi: 10.1007/s003300000618.
The application of a contrast-enhanced, two-dimensional MR technique, which provides dynamic projection angiograms at a subsecond temporal frame rate for depiction of the cervical and intracranial arteries, was evaluated in three healthy volunteers and seven patients with various cervicocranial steno-occlusive diseases. Intra-arterial digital subtraction angiography (DSA) served as standard of reference for findings in the patients. Magnetic resonance projection angiography (MRPA) was performed on a standard 1.5-T clinical MR imaging system at intravenous injection of a single dose of contrast agent (0.1 mmol/kg GdDTPA-BMA). Sixty consecutive images of the cerebral circulation were acquired at a temporal frame rate of 900 ms per image in the coronal plane. The collateral flow and the perfusion of the compromised vessel territory were readily assessed by MPRA in patients with occlusion of the internal cerebral artery (ICA) or middle cerebral artery (MCA). The leptomeningeal collateralisation of these patients was displayed in a dynamic fashion. Furthermore, quantitative perfusion measurement provided a difference between both MCA territories in the time to peak (deltaDTTP) of the contrast bolus of 1.12 +/- 0.28 s in five patients with severe stenosis or occlusion of the ICA (healthy volunteers 0.19 +/- 0.05 s). However, important pathological findings, such as the evaluation of carotid artery stenoses and the intracranial collateral flow pattern in patients with severe carotid stenoses, were not sufficiently assessable as compared with DSA. We conclude that the possibility of obtaining simultaneously information about morphology and perfusion dynamics of the cervicocranial vessels is unique in MPRA as compared with other MR techniques. However, in the applied form, the technique is not a reliable tool for the complete evaluation of the cervicocranial vessels in patients with steno-occlusive disease.
一种对比增强的二维磁共振技术可在亚秒级时间帧率下提供动态投影血管造影，用于显示颈内动脉和颅内动脉，对3名健康志愿者和7名患有各种颈颅狭窄闭塞性疾病的患者进行了该技术的评估。动脉内数字减影血管造影（DSA）作为患者检查结果的参考标准。在标准的1.5-T临床磁共振成像系统上，静脉注射单剂量造影剂（0.1 mmol/kg钆喷酸葡胺）后进行磁共振投影血管造影（MRPA）。在冠状面以每张图像900毫秒的时间帧率获取60幅连续的脑循环图像。在大脑中动脉（MCA）或颈内动脉（ICA）闭塞的患者中，通过MRPA可以很容易地评估侧支血流和受损血管区域的灌注情况。这些患者的软脑膜侧支循环以动态方式显示。此外，定量灌注测量显示，在5名ICA严重狭窄或闭塞的患者中，两个MCA区域造影剂团注的达峰时间（deltaDTTP）差值为1.12±0.28秒（健康志愿者为0.19±0.05秒）。然而，与DSA相比，一些重要的病理发现，如颈动脉狭窄的评估以及严重颈动脉狭窄患者的颅内侧支血流模式，无法得到充分评估。我们得出结论，与其他磁共振技术相比，MRPA能够同时获取颈颅血管形态和灌注动力学信息，这一点是独特的。然而，就目前应用形式而言，该技术并非评估狭窄闭塞性疾病患者颈颅血管的可靠工具。
