Brown Ryan, Nguyen Thanh D, Spincemaille Pascal, Prince Martin R, Wang Yi
Department of Radiology, Weill Medical College of Cornell University, New York, New York, USA.
J Magn Reson Imaging. 2009 May;29(5):1116-24. doi: 10.1002/jmri.21700.
To quantify femoral-popliteal vessel deformation during thigh contraction.
Eleven subjects underwent a magnetic resonance (MR) examination of the femoral-popliteal vasculature on a 1.5 T system. A custom 3D balanced steady-state free precession (SSFP) sequence was implemented to image a 15-20-cm segment of the vasculature during relaxation and voluntary isometric thigh contraction. The arterial and venous lumina were outlined using a semiautomated method. For the artery, this outline was fit to an ellipse whose aspect ratio was used to describe arterial deformation, while venous deformation was characterized by its cross-sectional area.
Focal compression of the femoral-popliteal artery during contraction was observed 94-143 mm superior to the condyle that corresponds to the distal adductor canal (AC) immediately superior to the adductor hiatus. This was illustrated by a significant reduction (P < or = 0.05) in aspect ratio from 0.88 +/- 0.06 during relaxation to 0.77 +/- 0.09 during contraction. A negligible change in arterial aspect ratio was observed inferior to the AC and in the proximal AC. Similarly, venous area was dramatically reduced in the distal AC region during contraction.
Rapid 3D SSFP MR angiography of the femoral-popliteal vasculature during thigh contraction demonstrated focal compression of the artery in the distal AC region. This may help explain the high stent failure rate and the high likelihood of atherosclerotic disease in the AC. J. Magn. Reson.
量化大腿收缩过程中股腘血管的变形情况。
11名受试者在1.5T系统上接受了股腘血管系统的磁共振(MR)检查。采用定制的三维稳态自由进动(SSFP)序列,在静息状态和自愿等长大腿收缩过程中对15 - 20厘米长的血管段进行成像。使用半自动方法勾勒出动脉和静脉管腔。对于动脉,该轮廓拟合为一个椭圆,其纵横比用于描述动脉变形,而静脉变形则通过其横截面积来表征。
在收缩过程中,观察到股腘动脉在对应于内收肌裂孔上方紧邻的远侧内收肌管(AC)的髁上方94 - 143毫米处出现局灶性压迫。这表现为纵横比从静息时的0.88±0.06显著降低(P≤0.05)至收缩时的0.77±0.09。在内收肌管下方和近端内收肌管处观察到动脉纵横比的变化可忽略不计。同样,在收缩过程中,远侧内收肌管区域的静脉面积显著减小。
大腿收缩过程中股腘血管系统的快速三维SSFP MR血管造影显示远侧内收肌管区域的动脉出现局灶性压迫。这可能有助于解释内收肌管中支架失败率高和动脉粥样硬化疾病可能性大的原因。《磁共振杂志》