手动脉非增强磁共振血管成像的初步临床应用

摘要

Purpose To assess the clinical application of non-contrast-enhanced MR angiography (NCE-MRA) using flow sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for displaying hand arteries of patients with rheumatoid arthritis. Materials and Methods Twenty-two patients with rheumatoid arthritis were recruited in this study. All the patients undertook hand NCE-MRA and three-dimensional dynamic CE-MRA on a 1.5T MR scanner. The informed consent was obtained from each subject. Image quality was assessed independently by two experienced radiologists at three arterial segments (wrist arteries, palm arteries, andfinger arteries) with a four-point scale. Signal to noise ratio (SNR), contrast to noise ratio (CNR), and vessel sharpness were evaluated by a magnetic resonance physicist. The results and image quality were statistically compared between the two MRA techniques.Results Twenty-two patients of 24 hands successfully underwent NCE-MRA and CE-MRA scan. Among 72 vascular segments, 69 segments of NCE-MRA were diagnostic, which was higher than that of CE-MRA (96% vs 83%,P<0.05). Otherwise, the image quality, SNR, CNR and vessel sharpness of NCE-MRA were all superior to those of CE-MRA (P<0.05).Conclusion NCE-MRA using FSD-prepared SSFP allows clear depiction of the hand arterial tree, and the image quality is superior to that of dynamic CE-MRA. It is a potential tool for evaluating the disease of hand arteries.%目的初步探讨基于血流敏感散相（FSD）和平衡稳态自由进动（SSFP）的非增强磁共振血管成像（NCE-MRA）技术在显示类风湿性关节炎患者手动脉的临床应用价值。资料与方法22例类风湿性关节炎患者采用1.5T成像系统进行手动脉NCE-MRA和增强磁共振血管成像（CE-MRA）检查。对手动脉（划分为腕部、掌部和指部3个血管节段）的图像质量进行评分，并对图像信噪比（SNR）、对比度噪声比（CNR）和血管边缘锐利度进行测量。将NCE-MRA和CE-MRA的图像质量和测量值进行统计学比较。结果22例患者24只手均成功完成NCE-MRA和动态CE-MRA检查。72个血管节段中，NCE-MRA有69个动脉节段的图像质量具有诊断意义，明显高于CE-MRA（96%比83%，P<0.05）。此外，NCE-MRA在手动脉各个部位的图像质量以及SNR、CNR和血管锐利度均优于CE-MRA（P<0.05）。结论 NCE-MRA能清楚地显示手动脉的各个分支，图像质量优于动态CE-MRA，对手动脉病变的诊断具有较好的临床应用潜力。