Grenier N, Brichaux J C, Degreze P, Douws C, Palussière J, Trillaud H
Service de Radiologie, Groupe Hospitalier Pellegrin, Bordeaux.
Ann Radiol (Paris). 1995;38(1-2):69-78.
Major clinical challenges are involved in applications of MR-angiography for the study of renal arteries, mostly for the diagnosis of renovascular hypertension. This technique now competes with color Doppler flow sonography and spiral CT. MR angiography of the renal arteries can be performed with 2D or 3D, flight-time or phase contrast sequences. Main and co-dominant arteries are usual by visualized on all sequences, but small accessory arteries are often missed. The diagnosis of stenosis is based on the presence of an area of signal extinction. The degree of extinction depends on the degree of turbulence, the type of technique, the length of TE and spatial resolution parameters, which is why scoring of stenoses is difficult and frequently overestimated. The diagnostic performance for stenosis is between 50 and 100% for sensitivity and between 80 and 97% for specificity. Detection of distal stenoses is poor because of respiratory artifacts. Multiphase acquisitions make it possible to measure the renal blood flow on each renal artery, adding hemodynamic criteria to this diagnosis.
磁共振血管造影在肾动脉研究中的应用面临着重大临床挑战,主要用于肾血管性高血压的诊断。这项技术目前可与彩色多普勒血流超声和螺旋CT相媲美。肾动脉磁共振血管造影可以使用二维或三维、飞行时间或相位对比序列来进行。在所有序列上通常都能显示主要和共同主导动脉,但小的副动脉常常会被遗漏。狭窄的诊断基于信号消失区域的存在。消失程度取决于湍流程度、技术类型、回波时间长度和空间分辨率参数,这就是为什么狭窄评分困难且经常被高估的原因。狭窄诊断的敏感性在50%至100%之间,特异性在80%至97%之间。由于呼吸伪影,远端狭窄的检测效果较差。多期采集能够测量每条肾动脉的肾血流量,为该诊断增加了血流动力学标准。