Michaely H J, Herrmann K A, Kramer H, Laub G, Reiser M F, Schoenberg S O
Institut für Klinische Radiologie, Klinikum der Universität München-Grosshadern.
Radiologe. 2004 Oct;44(10):975-84. doi: 10.1007/s00117-004-1110-0.
Arteriosclerosis of the supra-aortic vessels is a known risk factor for cerebrovascular disease. Large multicenter studies like NASCET and ECST have proven the protective effects of the surgical treatment of severe (>70%) carotid artery stenoses. The exact detection and grading of stenoses of the carotid arteries is a prerequisite for a successful therapy. Besides the gold-standard examination, digital subtraction angiography (DSA), MR angiography (MRA) is being used increasingly. MRA allows a non-invasive, high-resolution depiction of the supra-aortic vessels without ionizing radiation in only 20 s. This article first illustrates the MRA-techniques, and the indications and limitations of MRA. Next, the diagnostic accuracy of MRA is compared to DSA and ultrasound. The clinical value of MRA for the detection of stenoses of the carotid arteries is discussed on the basis of clinical examples.
主动脉弓上血管的动脉硬化是已知的脑血管疾病危险因素。像北美症状性颈动脉内膜切除术试验（NASCET）和欧洲颈动脉外科试验（ECST）这样的大型多中心研究已经证实了手术治疗严重（>70%）颈动脉狭窄的保护作用。准确检测和分级颈动脉狭窄是成功治疗的前提。除了金标准检查数字减影血管造影（DSA）外，磁共振血管造影（MRA）的应用也越来越多。MRA能够在仅20秒内无创、高分辨率地显示主动脉弓上血管，且无需电离辐射。本文首先阐述了MRA技术以及MRA的适应证和局限性。接下来，将MRA的诊断准确性与DSA和超声进行比较。并基于临床实例讨论了MRA在检测颈动脉狭窄方面的临床价值。
