Preliminary evaluation of 3D TOF MRA fly-around advantages in the diagnosis of internal carotid artery aneurysms
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 4
- DOI:
- 10.3760/j.issn:1005-1201.2004.04.012
- Key Word:
- 磁共振血管造影;体层摄影术,X线计算机;血管造影术,数字减影;颈内动脉瘤
Abstract： 目的与多层面螺旋CT三维血管造影(MS 3D-CTA)和DSA比较,探讨三维时间飞跃法MR血管造影(three dimensional time of flight MRA,3D TOF MRA)图像后处理血液铸型技术(fly-around)诊断颈内动脉系颅内动脉瘤的优势和临床应用价值.方法 18名疑诊颈内动脉系颅内动脉瘤病人,男4例,女14例;年龄17～76岁,平均49.8岁;其中蛛网膜下腔出血(SAH)14例、动眼神经麻痹4例.所有病人均接受3D TOF MRA和MS 3D-CTA检查,17名接受DSA检查,确诊后均经手术治疗.3D TOF MRA用Toshiba 1.5 T超导型MR系统VISART的3D-TOF序列采集原始数据.其参数为:TR 30 ms,TE 6.8 ms,反转角20°,视野(FOV)17 cm×19 cm,矩阵160×256,采集层块厚度50～60 mm,层厚1.2 mm;原始图像后处理方法采用最大密度投影(MIP)和血液铸型.MS 3D-CTA用Toshiba多层螺旋CT-Aquilion 采集原始数据.其参数为:扫描速度0.5 s/r,层厚1.0 mm,螺距3.5;用高压注射器静脉注射非离子型对比剂,注射剂量2.0 ml/ kg体重,注射流率4.0～5.0 ml/ s,延迟时间15～18 s;原始图像后处理方法同3D TOF MRA.图像后处理工作站均用SGI O2,后处理软件为Alatoview,版本1.42. DSA用Siemens Multi-Start OT经股动脉插管行常规脑动脉四血管造影.结果 3D TOF MRA 和MS 3D-CTA检出颅内动脉瘤22个:前动脉瘤1个,前交通动脉瘤3个,左中动脉瘤 1个,颈内动脉海绵窦段动脉瘤2个,左后交通动脉瘤3个,右后交通动脉瘤8个,左脉络膜前动脉瘤 1个,右脉络膜前动脉瘤2个,垂体上动脉瘤1个;DSA有1例未确定诊断,1例瘤颈状态不清晰. 1例右后交通动脉瘤仅依据3D TOF MRA 和MS 3D-CTA诊断结果行动脉瘤夹闭手术治疗.3D TOF MRA 血液铸型准确显示全部22个动脉瘤,其中最大瘤体直径为24 mm,最小瘤体直径为2.5 mm,瘤体直径<4 mm的动脉瘤有7例,占31.8%(7/22),检出率为100%.血液铸型图像中瘤体、瘤颈和载瘤动脉三维空间关系的显示均清晰、确切.结论 3D TOF MRA 血液铸型是诊断颈内动脉系特别是与颅底骨和海绵窦结构关系紧密的颅内动脉瘤非常有效的方法.
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