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[胸腹主动脉的二维时间飞跃法血管造影磁共振成像。技术与临床应用]

[2D TOF angio-MR of the thoraco-abdominal aorta. Technique and clinical applications].

作者信息

Iezzi A, Tartaro A, Magarelli N, Guidotti S, Tonni G, Carriero A

机构信息

Istituto di Scienze Radiologiche, Università G. D'Annunzio, Chieti.

出版信息

Radiol Med. 1993 Apr;85(4):364-9.

PMID:8516460
Abstract

The diagnostic role of Magnetic Resonance Angiography (MRA) was investigated in the study of the thoracic and abdominal aorta. Thirty-two patients with different conditions were examined: the thoracic aorta was affected in 7 cases (3 aneurysms, 2 dissections, 2 tumors) and the abdominal aorta in 25 cases (21 aneurysms, 3 stenoses and 1 dissection). Moreover, 2 kinkings and 1 dextroposition of the thoracic aorta were observed as occasional findings, together with 15 abdominal aorta kinking cases. A 1.5-T superconductive magnet (Magnetom, Siemens) with circular polarization body coil and the 2D TOF (FL 18 degrees, TR 30 ms, TE 10 ms, ST 5 mm, 1-mm overlap) technique were used. The images acquired on the coronal and sagittal or parasagittal planes were rotated from -45 degrees to 45 degrees and from 60 degrees to 120 degrees during post-processing, according to MIP. Digital angiography was the gold standard in all cases, angiography and CT were the gold standards for aneurysms, and surgery for the lesions reaching the thoracic aorta. The 2D TOF technique allowed excellent visualization of both the thoracic and the abdominal aorta. In thoracic aorta conditions, MRA always identified aneurysms and assessed their relationship to epiaortic branchings. Moreover, MRA identified 2 cases of thoracic aorta dissection. In one case (1/2) MRA failed to depict aortic wall infiltration by tumor. In 21 abdominal aorta aneurysms, MRA always correctly demonstrated both the extent of the aneurysm and its relationships to renal and iliac arteries. Moreover, the thrombotic aneurysmal component was demonstrated, together with left renal vein course, which was retroaortic in 4 cases. Abnormal course, stenoses (2 cases) and dissection of the abdominal aorta were always identified by MRA.

摘要

本研究探讨了磁共振血管造影(MRA)在胸主动脉和腹主动脉研究中的诊断作用。对32例不同病情的患者进行了检查:7例累及胸主动脉(3例动脉瘤、2例夹层、2例肿瘤),25例累及腹主动脉(21例动脉瘤、3例狭窄和1例夹层)。此外,偶然发现2例胸主动脉扭结和1例胸主动脉右旋,以及15例腹主动脉扭结病例。使用一台配备圆极化体线圈的1.5T超导磁体(西门子Magnetom)和二维时间飞跃法(翻转角18°,重复时间30ms,回波时间10ms,层厚5mm,层间距1mm)技术。根据最大密度投影(MIP),在图像后处理过程中,将在冠状面和矢状面或旁矢状面采集的图像旋转-45°至45°以及60°至120°。数字血管造影在所有病例中均为金标准,血管造影和CT是动脉瘤的金标准,而对于累及胸主动脉的病变,手术是金标准。二维时间飞跃法技术能够很好地显示胸主动脉和腹主动脉。在胸主动脉病变中,MRA总能识别出动脉瘤并评估其与主动脉上分支的关系。此外,MRA还识别出2例胸主动脉夹层。在1例(1/2)病例中,MRA未能显示肿瘤对主动脉壁的浸润。在21例腹主动脉瘤中,MRA总能正确显示动脉瘤的范围及其与肾动脉和髂动脉的关系。此外,还显示了血栓形成的动脉瘤成分以及左肾静脉走行,其中4例左肾静脉走行于主动脉后方。MRA总能识别出腹主动脉的走行异常、狭窄(2例)和夹层。

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