Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg Eppendorf.
Department of Anesthesia, Schoenklinik.
Circ J. 2018 Aug 24;82(9):2364-2371. doi: 10.1253/circj.CJ-18-0414. Epub 2018 Jul 10.
To determine the type and frequency of vascular and organ malformations in adults with thalidomide embryopathy (TE) using non-contrast magnetic resonance angiography (MRA) and to assess the effect of the observed malformations on renal function.
The institutional ethics committee approved this prospective study and written informed consent was given by all 78 subjects (50 females) with TE (mean age: 55±1.1 years), who were examined by non-contrast MRA at 3T. ECG-triggered balanced turbo field echo images of the chest, abdomen and pelvis were obtained in coronal and sagittal orientations. Two observers assessed the frequency of vascular and organ malformations. Serum creatinine and estimated glomerular filtration rate (eGFR) were obtained to assess renal function. In 58 subjects, 99 vascular anomalies were observed, including 68 arterial (69%) and 31 venous anomalies (31%); 15 patients had 16 abdominal organ malformations including 12 kidney anomalies and 4 cases of gallbladder agenesis. Most vascular anomalies affected the renal vessels (n=66, 67%) or supraaortic arteries (n=28, 28%). Serum creatinine and eGFR revealed normal renal function in all subjects.
Vascular and organ anomalies occurred in a high number of subjects with TE without evidence of renal dysfunction. Information about the presence of malformations may be important for future surgical interventions in subjects with TE.
使用非对比磁共振血管造影(MRA)确定噻替啶胚胎病(TE)成人的血管和器官畸形的类型和频率,并评估观察到的畸形对肾功能的影响。
机构伦理委员会批准了这项前瞻性研究,所有 78 名 TE 患者(50 名女性,平均年龄:55±1.1 岁)均签署了书面知情同意书,他们在 3T 下接受非对比 MRA 检查。使用 ECG 触发的平衡涡轮场回波图像对胸部、腹部和骨盆进行冠状和矢状位采集。两名观察者评估了血管和器官畸形的频率。获得血清肌酐和估算肾小球滤过率(eGFR)以评估肾功能。在 58 名患者中,观察到 99 个血管异常,包括 68 个动脉(69%)和 31 个静脉异常(31%);15 名患者有 16 个腹部器官畸形,包括 12 个肾脏异常和 4 例胆囊缺如。大多数血管异常影响肾血管(n=66,67%)或主动脉以上动脉(n=28,28%)。所有患者的血清肌酐和 eGFR 均显示正常肾功能。
TE 患者中存在大量血管和器官畸形,但无肾功能障碍的证据。有关畸形存在的信息对于 TE 患者未来的手术干预可能很重要。