Shetty A N, Bis K G, Vrachliotis T G, Kirsch M, Shirkhoda A, Ellwood R
Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
J Magn Reson Imaging. 1998 May-Jun;8(3):603-15. doi: 10.1002/jmri.1880080314.
The objective of this study was to determine the clinical utility of a contrast-enhanced, centric reordered, three-dimensional (3D) MR angiography (MRA) pulse sequence in imaging the abdominal aorta and renal and peripheral lower extremity arteries. Twenty-eight MRA studies were performed on 23 patients and four volunteers at 1.5 T using a 3D contrast-enhanced, centric reordered pulse sequence. In 20 patients, the abdominal aorta and renal arteries were imaged, and in seven patients, the lower extremity arteries were imaged. In 19 patients, a total of 51 renal vessels were evaluated (33 renal arteries using .1 mmol/kg of gadopentetate dimeglumine and 18 renal arteries using .2 mmol/kg of gadoteridol). A total of 70 peripheral arterial segments were assessed using .2 mmol/kg of gadoteridol. Correlation with conventional angiography was made for the following 14 cases: renal artery stenosis (four cases), abdominal aortic stenosis (one case), arteriovenous fistula in a transplant kidney (one case), renal arteriovenous malformation (one case), common iliac artery aneurysms (one case), and peripheral lower extremity (six cases). Of the 70 peripheral arterial segments evaluated, in 35, there was correlation with x-ray angiography. The mean percent of aortic signal enhancement was significantly higher in the .2 mmol/kg dose group (370.8 +/- 190.3) than in the .1 mmol/kg dose group (184.5 +/- 128.9) (P = .02). However, there was no apparent difference between the two doses for visualization of the renal and accessory renal arteries. There was concordance between the contrast-enhanced 3D MRA studies and conventional angiography in all cases of renal artery and peripheral arterial stenoses and occlusions, including visualization of reconstituted peripheral arterial segments. There was no evidence of spin dephasing effects at sites of stenoses on the 3D contrast-enhanced MRA studies. Contrast-enhanced, centric reordered, 3D MRA can rapidly image the abdominal aorta and renal and accessory renal arteries, as well as peripheral lower extremity arteries, with high resolution. Accurate depiction of the vascular lumen at sites of stenosis is made because of the lack of spin dephasing effects, even with hemodynamically significant stenoses. Additional larger clinical trials are required with this promising technique.
本研究的目的是确定一种对比增强、中心重排序的三维（3D）磁共振血管造影（MRA）脉冲序列在腹主动脉、肾动脉及下肢外周动脉成像中的临床应用价值。对23例患者和4名志愿者在1.5T场强下使用3D对比增强、中心重排序脉冲序列进行了28项MRA研究。20例患者对腹主动脉和肾动脉进行了成像，7例患者对下肢动脉进行了成像。19例患者共评估了51支肾血管（33支肾动脉使用0.1mmol/kg钆喷酸葡胺，18支肾动脉使用0.2mmol/kg钆特醇）。使用0.2mmol/kg钆特醇共评估了70个外周动脉节段。对以下14例病例与传统血管造影进行了相关性分析：肾动脉狭窄（4例）、腹主动脉狭窄（1例）、移植肾动静脉瘘（1例）、肾动静脉畸形（1例）、髂总动脉瘤（1例）及下肢外周动脉（6例）。在评估的70个外周动脉节段中，35个与X线血管造影有相关性。0.2mmol/kg剂量组主动脉信号增强的平均百分比（370.8±190.3）显著高于0.1mmol/kg剂量组（184.5±128.9）（P = 0.02）。然而，对于肾动脉和副肾动脉的显示，两种剂量之间没有明显差异。在所有肾动脉和外周动脉狭窄及闭塞病例中，包括对外周动脉重建节段的显示，对比增强3D MRA研究与传统血管造影之间具有一致性。在3D对比增强MRA研究中，狭窄部位没有自旋去相位效应的证据。对比增强、中心重排序的3D MRA能够快速对腹主动脉、肾动脉及副肾动脉以及下肢外周动脉进行高分辨率成像。由于没有自旋去相位效应，即使是血流动力学上有显著意义的狭窄，也能准确描绘狭窄部位的血管腔。需要对这种有前景的技术进行更多更大规模的临床试验。
