Takehara Yasuo, Yamashita Shuhei, Sakahara Harumi, Masui Takayuki, Isoda Haruo
Radiology, Hamamatsu University Hospital, Hamamatsu, Shizuoka, Japan.
Ann Vasc Dis. 2011;4(4):271-85. doi: 10.3400/avd.di.11.00822. Epub 2011 Nov 30.
Magnetic resonance angiography (MRA) is capable of imaging arteries in the half to whole body by a single acquisition without a nephrotoxic contrast medium, and acquired images can be reconstructed into a specific cross-sectional view in an arbitrary directions. MRA is applicable for vessels non-reachable by a catheter approach, and collateral vessels can be fully visualized. Since MRA is minimally-invasive with no exposure to ionized radiation, it can be repeatedly applied for follow-up. However, there are also disadvantages: the temporal and spatial resolutions are inferior to those of X-ray angiography, and, at present, it cannot be used as a guide for intervention. Moreover, gadolinium administrations may cause NSF in patients who have lost renal function, as a new risk. Accordingly, strict consideration is required for an indication of its application. Development of non-contrast MRA and evaluation of the wall itself may draw more attention in the future. Plaque imaging is being routinely performed nowadays, and the measurement of vascular wall shear stress, which has a close association with arteriosclerosis, may become possible by utilizing the time-resolved phase-contrast method capable of measuring the time-resolved velocity vectors of blood flow throughout the body. (*English Translation of J Jpn Coll Angiol, 2009, 49: 503-516.).
磁共振血管造影(MRA)能够在不使用肾毒性造影剂的情况下,通过一次采集对半身至全身的动脉进行成像,并且采集到的图像可以重建为任意方向的特定横截面视图。MRA适用于导管无法到达的血管,并且可以清晰显示侧支血管。由于MRA微创且不暴露于电离辐射,因此可重复用于随访。然而,它也存在缺点:时间和空间分辨率低于X射线血管造影,并且目前不能用作介入的引导。此外,钆剂给药可能会在肾功能丧失的患者中引发 NSF,这是一种新的风险。因此,在应用指征方面需要严格考虑。非对比MRA的发展以及血管壁本身的评估可能在未来受到更多关注。如今斑块成像已常规进行,并且利用能够测量全身血流时间分辨速度矢量的时间分辨相位对比法,有可能实现与动脉硬化密切相关的血管壁剪切应力的测量。(日本血管外科学会杂志英文译文,2009 年,49: 503 - 516)