Davis C P, Schöpke W D, Seifert B, Schneider E, Pfammatter T, Debatin J F
Department of Radiology, University Hospital, Zürich, Switzerland.
AJR Am J Roentgenol. 1997 Apr;168(4):1027-34. doi: 10.2214/ajr.168.4.9124109.
This study was performed to evaluate the feasibility of using MR angiography for following up patients who have undergone interventional therapy of the infrapopliteal vascular bed.
Fourteen patients with peripheral vascular disease underwent MR imaging before and after percutaneous transluminal angioplasty (PTA) using a two-dimensional time-of-flight technique (TR/TE, 33/3.9; section thickness, 2.9 mm). As the gold standard, selective digital subtraction angiography was obtained for all evaluated extremities before and after PTA. For data analysis, the distal peripheral arterial system was divided into 11 segments: the popliteal artery; the tibioperoneal trunk; and the proximal, mid, and distal portions of the three trifurcation vessels. Each segment was characterized as normal, mildly diseased, moderately diseased, severely diseased, or occluded.
We found overall agreement between the two techniques in 110 segments (71%) and 123 segments (80%) on data obtained before and after PTA, respectively. Before PTA, our interpretation of MR angiograms overestimated 14 lesions (9%). After PTA, we overestimated five lesions (3%) on MR angiograms. We underestimated lesion severity in 30 cases (19%). The high incidence of agreement between the two techniques was reflected by the high Kendall's tau-beta values of .83 and .87 for data obtained before and after PTA, respectively.
The excellent depiction of the PTA-induced morphologic changes suggests great potential for the use of MR angiograms during interventional follow-up.
本研究旨在评估使用磁共振血管造影术对接受腘下血管床介入治疗的患者进行随访的可行性。
14例周围血管疾病患者在经皮腔内血管成形术（PTA）前后采用二维时间飞跃技术（TR/TE，33/3.9；层厚，2.9 mm）进行磁共振成像。作为金标准，所有评估肢体在PTA前后均进行选择性数字减影血管造影。数据分析时，将远端外周动脉系统分为11个节段：腘动脉；胫腓干；以及三支分叉血管的近端、中段和远端部分。每个节段分为正常、轻度病变、中度病变、重度病变或闭塞。
我们发现，在PTA前后获得的数据中，两种技术在110个节段（71%）和123个节段（80%）上总体一致。在PTA前，我们对磁共振血管造影的解读高估了14处病变（9%）。在PTA后，我们在磁共振血管造影上高估了5处病变（3%）。我们低估了30例病变的严重程度（19%）。两种技术之间的高一致性发生率分别通过PTA前后获得的数据的高肯德尔tau-beta值0.83和0.87得到反映。
PTA引起的形态学变化的出色描绘表明，磁共振血管造影在介入随访中具有巨大的应用潜力。
