Prince M R, Narasimham D L, Stanley J C, Wakefield T W, Messina L M, Zelenock G B, Jacoby W T, Marx M V, Williams D M, Cho K J
Department of Radiology, University of Michigan, Ann Arbor, USA.
J Vasc Surg. 1995 Apr;21(4):656-69. doi: 10.1016/s0741-5214(95)70197-4.
The objective of this study was to assess the usefulness of gadolinum-enhanced magnetic resonance angiography (MRA) for defining anatomic features relevant to performing aortic surgery for aneurysmal disease.
Anatomic data defined by MRA, including abdominal aortic aneurysm (AAA) size and character, as well as the status of the celiac, mesenteric, renal, and iliac arteries, were correlated with angiography, ultrasonography, computed tomography, or operative data in 43 patients. Five MRA sequences were obtained in an hour-long examination optimized for aortoiliac, splanchnic, and renal artery imaging at 1.5 T in a body coil. Four of the sequences were performed during or after infusion of gadolinium to improve image quality.
MRA correctly defined the maximum aneurysm diameter, as well as its proximal and distal extent in all patients. MRA detected 33 of 35 significant stenoses among 153 splanchnic, renal, or iliac branches examined (sensitivity = 94% and specificity = 98%). MRA did not resolve the degree of aortic branch stenotic disease sufficiently to precisely grade its severity. MRA did not reliably define the status of the inferior mesenteric artery, lumbar arteries or internal iliac arteries. One ruptured AAA and one inflammatory AAA were correctly diagnosed by MRA. No patient had a contrast reaction or contrast-induced renal toxicity related to administration of gadolinium.
Gadolinium-enhanced MRA of AAA provides appropriate, essential anatomic information for aortic reconstructive surgery in a 1-hour examination devoid of contrast-related renal toxicity or catheterization-related complications attending conventional arteriography.
本研究的目的是评估钆增强磁共振血管造影（MRA）在确定与动脉瘤性疾病主动脉手术相关的解剖特征方面的实用性。
将MRA定义的解剖学数据，包括腹主动脉瘤（AAA）的大小和特征，以及腹腔干、肠系膜、肾和髂动脉的状况，与43例患者的血管造影、超声检查、计算机断层扫描或手术数据进行关联。在1.5T体线圈中，通过长达一小时的检查获得五个MRA序列，该检查针对腹主动脉、内脏和肾动脉成像进行了优化。其中四个序列在注入钆期间或之后进行，以提高图像质量。
MRA正确定义了所有患者动脉瘤的最大直径及其近端和远端范围。在检查的153个内脏、肾或髂分支中，MRA检测出35个显著狭窄中的33个（敏感性=94%，特异性=98%）。MRA不能充分分辨主动脉分支狭窄疾病的程度，无法精确分级其严重程度。MRA不能可靠地确定肠系膜下动脉、腰动脉或髂内动脉的状况。MRA正确诊断出1例破裂性AAA和1例炎性AAA。没有患者因注入钆出现造影剂反应或造影剂诱发的肾毒性。
AAA的钆增强MRA在1小时检查中为主动脉重建手术提供了适当的、必要的解剖学信息，且不存在传统动脉造影相关的造影剂肾毒性或导管插入相关并发症。
