基于多反转脉冲空间标记技术的非对比剂增强磁共振血管成像序列在评估移植肾血管解剖方面的研究

摘要

Objective:To evaluate the ability of unenhanced magnetic resonance angiography (MRA)using spatial la-beling with multiple inversion pulses (SLEEK)to depict anatomy of renal vascular transplant and to compare the results with color Doppler ultrasonography (CDUS)and intraoperative findings.Methods:All patients gave written informed con-sent before examination.75 patients with renal transplant were examined with unenhanced MRA using SLEEK and CDUS. The ability of SLEEK to show transplant renal vascular anatomy was evaluated in consensus by two experienced radiologists who compared the results with CDUS and intraoperative findings.Results:75 patients successfully underwent unenhanced MRA using SLEEK and CDUS.Three patients had two renal transplants.Image quality of 78 renal transplants was accepta-ble.The image quality was categorized as excellent in 85% (66 of 78),good in 10% (8 of 78)and moderate in 5% (4 of 78) of the patients.72 kidneys were transplanted into the right iliac fossa and 6 kidneys were transplanted into the left iliac fos-sa.Arterial connection of the renal artery was done as an end-to-side anastomosis with the external iliac artery in 43 cases, as end-to-end anastomosis with the internal iliac artery in 35 instances.The renal vein was connected by end-to-side anasto-mosis to the external iliac vein in all patients.Of the 9 accessory renal arteries in 9 patients,only 2 (22%)accessory arteries were depicted with CDUS,whereas 8 (89%)were depicted with SLEEK.Significantly more of accessory renal arteries were detected with SLEEK than with CDUS (P<0.05).Conclusion:Unenhanced MRA using SLEEK preliminarily proved to be a reliable diagnostic method for depiction of anatomy of renal vascular transplant.It may be used for evaluation of patients with renal transplant,and in particular for those with renal insufficiency.%目的：评估基于多反转脉冲空间标记技术（SLEEK）的非对比剂增强磁共振血管成像序列在显示移植肾血管解剖方面的价值，并和彩色多普勒超声（CDUS）及手术记录结果进行对照。方法：对75名肾移植术后需要排除血管并发症的患者进行CDUS及SLEEK扫描，所有患者均签署知情同意书。由两名放射科专家对SLEEK 显示移植肾血管解剖结构进行评估，并将SLEEK结果与CDUS及手术记录进行对照。结果：75名肾移植患者均成功进行了 SLEEK 扫描及CDUS扫描。3名患者移植了2个肾脏，总共有78个移植肾进行了图像评估，所有患者的图像质量都是可以接受的。图像质量评分为优秀的占85％（66／78），良好的占10％（8／78），一般的占5％（4／78）。在检查移植肾血管吻合方式方面， SLEEK检查结果与手术记录完全吻合，发现72个肾脏被移植在右侧髂窝，6个肾脏被移植在左侧髂窝。移植肾动脉与髂外动脉端侧吻合的有43个，移植肾动脉与髂内动脉端端吻合的有35个，所有78个移植肾静脉均与髂外静脉端侧吻合，结果与CDUS间差异无统计学意义（P＞0．05）。手术记录显示78个移植肾中有9个有副肾动脉，SLEEK发现了其中的8例，超声只发现了2例，SLEEK在检出副肾动脉方面明显优于CDUS（P＜0．05）。结论：基于SLEEK 的非对比剂增强磁共振血管成像被证明是显示移植肾血管解剖的一种可靠方法。SLEEK 可以作为评估移植肾血管的方法，尤其适用于肾功能不良的患者。