Ming Zhu, Yumin Zhong, Yuhua Li, Biao Jin, Aimin Sun, Qian Wang
Department of Radiology, Shanghai Children's Medical Center, Affiliated Xinhua Hospital of Shanghai Second Medical University, Shanghai, PR China.
J Cardiovasc Magn Reson. 2006;8(5):747-53. doi: 10.1080/10976640600737425.
The purpose of this study was to evaluate the accuracy of contrast-enhanced magnetic resonance angiography for the diagnosis of congenital obstructive aortic arch anomalies in children and compare it with transthoracic echocardiography and other MR imaging techniques (ECG gated T1-weighted spin-echo imaging and gradient-echo cine imaging).
Contrast-enhanced magnetic resonance angiography, ECG gated T1-weighted spin-echo imaging, and gradient-echo cine imaging were performed for the diagnosis of congenital obstructive aortic arch anomalies in 416 patients from April 1999 to March 2005 (age range, 3 days to 12 years; mean age, 2.4 years) using a GE 1.5T MR scanner. Transthoracic echocardiography was performed in all patients prior to MR examination. Surgery and/or conventional X-ray angiocardiography were done in all patients to determine the final diagnosis.
The population consisted of 416 patients. Congenital obstructive aortic arch anomalies were diagnosed in 213 patients and ruled out in 203 patients by operation and/or conventional X-ray angiocardiography. Among the 213 patients with anomalies, coarctation of aorta was diagnosed in 174, interruption of aortic arch was diagnosed in 35, and persistent fifth aortic arch with fourth aortic arch interruption was diagnosed in 4 patients. Among the 35 patients with interruption of aortic arch, 21 were of type A, and 14 were of type B. The diagnostic sensitivity, specificity and accuracy of contrast-enhanced magnetic resonance angiography for congenital obstructive aortic arch anomalies were 98% (208/213), 99% (201/203) and 98% (409/416), respectively. The diagnostic sensitivity, specificity and accuracy of transthoracic echocardiography were 88% (187/213), 92% (186/203) and 90% (373/416), respectively. The diagnostic sensitivity, specificity and accuracy of other MR imaging techniques (ECG gated T1-weighted spin-echo imaging and gradient-echo cine imaging) were 89% (189/213), 84% (170/203) and 86% (359/416), respectively.
Contrast-enhanced magnetic resonance angiography is a reliable, noninvasive imaging technique for the diagnosis of congenital obstructive aortic arch anomalies in children. Occasionally, even more information can be obtained from this technique than from conventional X-ray angiocardiography. Contrast-enhanced magnetic resonance angiography is superior to transthoracic echocardiography and other MR imaging techniques (ECG gated T1-weighted spin-echo imaging and gradient-echo cine imaging) for diagnosis of congenital obstructive aortic arch anomalies in children.
本研究旨在评估对比增强磁共振血管造影术诊断儿童先天性梗阻性主动脉弓异常的准确性，并将其与经胸超声心动图及其他磁共振成像技术（心电图门控T1加权自旋回波成像和梯度回波电影成像）进行比较。
1999年4月至2005年3月，使用GE 1.5T磁共振扫描仪，对416例患者（年龄范围3天至12岁，平均年龄2.4岁）进行对比增强磁共振血管造影术、心电图门控T1加权自旋回波成像和梯度回波电影成像，以诊断先天性梗阻性主动脉弓异常。所有患者在磁共振检查前均进行了经胸超声心动图检查。所有患者均接受手术和/或传统X线心血管造影检查以确定最终诊断。
研究对象共416例患者。通过手术和/或传统X线心血管造影检查，213例患者被诊断为先天性梗阻性主动脉弓异常，203例患者被排除。在213例异常患者中，174例诊断为主动脉缩窄，35例诊断为主动脉弓中断，4例诊断为永存第五主动脉弓伴第四主动脉弓中断。在35例主动脉弓中断患者中，21例为A型，14例为B型。对比增强磁共振血管造影术诊断先天性梗阻性主动脉弓异常的敏感性、特异性和准确性分别为98%（208/213）、99%（201/203）和98%（409/416）。经胸超声心动图的诊断敏感性、特异性和准确性分别为88%（187/213）、92%（186/203）和90%（373/416）。其他磁共振成像技术（心电图门控T1加权自旋回波成像和梯度回波电影成像）的诊断敏感性、特异性和准确性分别为89%（189/213）、84%（170/203）和86%（359/416）。
对比增强磁共振血管造影术是诊断儿童先天性梗阻性主动脉弓异常的一种可靠的非侵入性成像技术。偶尔，从该技术中获得的信息甚至比传统X线心血管造影术更多。在诊断儿童先天性梗阻性主动脉弓异常方面，对比增强磁共振血管造影术优于经胸超声心动图及其他磁共振成像技术（心电图门控T1加权自旋回波成像和梯度回波电影成像）。
