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对比增强 MR 容积内插体部检查在肺栓塞和深静脉血栓形成中的联合 MRI 应用

Combined MR Imaging for Pulmonary Embolism and Deep Venous Thrombosis by Contrast-enhanced MR Volume Interpolated Body Examination.

机构信息

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.

出版信息

Curr Med Sci. 2020 Feb;40(1):192-198. doi: 10.1007/s11596-020-2164-6. Epub 2020 Mar 13.

Abstract

MR pulmonary angiography (MRPA) combined with indirect MR venography (MRV) was attempted by using 3D contrast-enhanced MR volume interpolated body examination (VIBE) sequence. Agreement rate for deep venous thrombosis (DVT) detection between MRV and duplex sonography (DUS) was evaluated; the potential of this method for venous thromoembolism (VTE) was also investigated. Thirty-four patients with DUS-identified DVT were enrolled in this study. MRI was performed after a single administration of Gadopentetate dimeglumine. Fat-suppressed 3D VIBE was applied for visualizing pulmonary arteries, abdominal veins, pelvic and leg veins, ranging from lung apex to ankle level. Two radiologists observed the MR images in consensus, recorded the location and number of emboli. MRV images were assessed based on per-vein segment. The agreement rate between MRV and DUS for venous segment-to-segment comparison was analyzed by Wilcoxon rank sum test. All the patients were diagnosed as having DVT by MRV. MRV detected 55 more venous segments with thrombi than DUS based on per-vein segment analysis. Twenty-three patients with pulmonary embolism (PE) were detected by MRPA. Twenty-one patients underwent both pulmonary CT angiography and MRPA, and consistency for PE detection was 100%. Total examination time of the combined MR protocol was 7 min for each patient. The contrast-enhanced VIBE sequence proves to be a feasible and reliable method for VTE diagnosis in one-stop MR scanning procedure, and contrast-enhanced VIBE performs better to depict DVT than DUS on per-vein segment basis.

摘要

采用三维对比增强磁共振容积内插体部检查(VIBE)序列进行磁共振肺动脉造影(MRPA)联合间接磁共振静脉造影(MRV)。评估 MRV 与双功能超声(DUS)对深静脉血栓形成(DVT)检测的一致性;还研究了该方法对静脉血栓栓塞症(VTE)的潜在价值。本研究纳入了 34 例经 DUS 诊断为 DVT 的患者。在单次钆喷替酸葡甲胺给药后进行 MRI 检查。应用脂肪抑制三维 VIBE 从肺尖到踝水平可视化肺动脉、腹部静脉、盆腔和下肢静脉。两名放射科医生共同观察 MR 图像,记录栓子的位置和数量。根据静脉段评估 MRV 图像。采用 Wilcoxon 秩和检验分析 MRV 和 DUS 对静脉节段到节段比较的一致性率。所有患者均通过 MRV 诊断为 DVT。基于静脉分段分析,MRV 比 DUS 多检测到 55 个有血栓的静脉段。MRPA 检出 23 例肺栓塞(PE)。21 例患者同时进行了肺部 CT 血管造影和 MRPA,PE 的检测一致性为 100%。联合 MR 方案的总检查时间为每位患者 7 分钟。增强 VIBE 序列在一站式 MR 扫描过程中证明是一种可行且可靠的 VTE 诊断方法,并且在静脉分段基础上,增强 VIBE 比 DUS 更能显示 DVT。

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