非增强磁共振血管成像在肾动脉狭窄评估方面的价值研究

doi:10.16150/j.1671-2870.2019.01.014

摘要/Abstract

摘要： 目的评价非增强磁共振血管成像（magnetic resonance angiography, MRA）技术在评估肾动脉狭窄方面的价值。方法对73例临床怀疑肾动脉狭窄的患者进行MRA检查，采用1.5T MRI设备结合呼吸触发技术先行非增强 MRA检查，再行增强 MRA检查。本研究以增强MRA为参考标准，对2种成像结果进行比较分析，包括图像质量、肾动脉狭窄程度评价的一致性及对肾动脉各级分支的显示情况。结果肾动脉非增强MRA和增强MRA在图像质量方面差异无统计学意义;在肾动脉狭窄评价方面，32根肾动脉被增强MRA诊断为肾动脉狭窄，非增强MRA提示29根肾动脉狭窄，不一致的有3根。其中1根不一致的原因是由于注射对比剂后采集过早;余2根显示不一致其原因是由于呼吸不均匀而导致。除了上述3根，在评估肾动脉狭窄方面，两者间具有很好的一致性（Kappa值为0.98）;肾动脉分支显示方面，非增强MRA明显优于增强MRA（P<0.001）。结论非增强MRA能全面显示肾动脉狭窄情况，在显示肾动脉分支方面优于增强MRA，具有重要的临床应用价值。

关键词: 肾动脉, 狭窄, 磁共振血管成像, 非增强磁共振血管成像

Abstract:

Objective: To study the value of non-enhanced MRA in assessment of renal artery stricture. Methods: A total of 73 patients with clinically suspected renal artery stricture undergone magnetic resonance angiography were enrolled. The 1.5T MR device combined with respiratory triggering technique was used to perform non-enhanced MRA and then enhanced MRA imaging was undertaken. The two imaging results were compared and analyzed for image quality, consistency of renal artery stricture evaluation and display of branches of renal artery. Results: There was no statistically significant difference in image quality between non-enhanced MRA and enhanced MRA of renal artery.In the evaluation of renal artery stricture, the two were in good agreement (Kappa value 0.98), The non-enhanced MRA showed better renal artery branches than enhanced MRA (P<0.001). Conclusions: Non-enhanced MRA can fully display the renal artery stricture, and it is superior to enhanced MRA in displaying renal artery branches. Therefore，non-enhanced MRA is of great importance in clinical practice.

Key words: Renal artery, stricture, Magnetic Resonance Angiography, non-enhanced magnetic resonance angiography

中图分类号:

R445.2

刘方韬, 齐晓凤, 徐学勤, 黄娟, 董海鹏, 倪根雄, 周雯, 孔德艳. 非增强磁共振血管成像在肾动脉狭窄评估方面的价值研究[J]. 诊断学理论与实践, 2019, 18(1): 72-76.

LIU Fangtao, QI Xiaofeng, XU Xueqin, HUANG Juan, DONG Haipeng, NI Genxiong, ZHOU Wen, KONG Deyan. Value of non-enhanced magnetic resonance angiography in assessing renal artery stricture[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(1): 72-76.

图/表 3

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项目	非增强MRA	增强MRA	P值
图像质量	3.29±0.74	3.22±0.89	0.612
肾动脉分支	2.99±0.70	2.32±0.57	<0.001
肾静脉伪影	4.99±0.12	4.47±0.55	<0.001

检查方法	肾动脉狭窄分级			合计
检查方法	1级	2级	3级	合计
非增强MRA	14	9	6	29
增强MRA	20	7	5	32