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[利用电影磁共振相位对比血流测量对肾动脉狭窄血流动力学变化进行分类]

[Classification of hemodynamic changes in renal artery stenosis using cine magnetic resonance phase contrast flow measurements].

作者信息

Schoenberg S O, Knopp M V, Bock M, Kallinowski F, Just A, Essig M, Hawighorst H, Zuna I, Schad L, Allenberg J R, van Kaick G

机构信息

Deutsches Krebsforschungszentrum (DKFZ), Abteilung Radiologische Diagnostik und Therapie, Heidelberg.

出版信息

Radiologe. 1997 Aug;37(8):651-62. doi: 10.1007/s001170050267.

Abstract

PURPOSE

To evaluate the use of high-temporal resolution cine MR phase-contrast flow measurements for assessment of flow dynamics in renal artery stenosis (RAS).

MATERIAL AND METHODS

In a dog model, cine MR flow measurements were validated by comparing the MR flow data to an invasive transit-time ultrasound reference technique for different degrees of RAS. Cardiac-gated MR flow curves were recorded in 56 renal arteries of 28 patients with a temporal resolution of at least 32 ms. In all cases RAS was confirmed by digital subtraction angiography (DSA). Abnormalities of flow dynamics were assessed in the calculated flow curves using the MR parameters mean flow, maximum velocity, and time to systolic maximum.

RESULTS

By means of the MR blood flow parameters high-grade stenoses (> 50%, n = 23) were detected with sensitivity of 100% and specificity of 94% with reference to DSA. The overall differentiation between stenoses (n = 37) and non-stenosed vessels (n = 19) revealed a sensitivity of 87% and a specificity of 100%.

CONCLUSION

Analysis of cardiac-gated MR flow curves provides a non-invasive method to assess the hemodynamic significance of RAS and thus allows a functional evaluation in relation to the morphologic characteristics of the stenosis.

摘要

目的

评估使用高时间分辨率电影磁共振相位对比血流测量技术来评估肾动脉狭窄(RAS)中的血流动力学。

材料与方法

在犬模型中,通过将磁共振血流数据与不同程度RAS的侵入性渡越时间超声参考技术进行比较,对电影磁共振血流测量进行验证。对28例患者的56条肾动脉记录了心脏门控磁共振血流曲线,时间分辨率至少为32毫秒。所有病例均通过数字减影血管造影(DSA)确诊为RAS。使用磁共振参数平均血流、最大速度和收缩期最大值时间,在计算出的血流曲线中评估血流动力学异常。

结果

借助磁共振血流参数,相对于DSA,检测出重度狭窄(>50%,n = 23)的灵敏度为100%,特异度为94%。狭窄血管(n = 37)与非狭窄血管(n = 19)之间的总体区分显示灵敏度为87%,特异度为100%。

结论

分析心脏门控磁共振血流曲线提供了一种非侵入性方法来评估RAS的血流动力学意义,从而能够对狭窄的形态学特征进行功能评估。

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