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目的探讨三维增强磁共振血管成像(3D CE MRA)在主动脉夹层诊断中的价值。方法对37例主动脉夹层病例行3D CE MRA检查,图像重建采用最大信号强度投影(MIP)和多层面重建(MPR)。增强扫描前行横断位FSE序列T1WI、T2WI,增强后再行横断位FSE T1WI,可疑撕裂口位置行Cine序列。重点观察主动脉夹层的分型、内膜瓣片、撕裂口以及真假腔等。结果 3D CE MRA的MIP图像对主动脉夹层诊断的敏感度为84%,特异度为100%。结合原始图和MPR图像,其敏感度可达到100%。(1)主动脉夹层的分型:Ⅰ型9例,占24.3%;Ⅱ型2例,占5.4%;Ⅲ型26例,占70.3%。(2)内膜瓣片的显示:常规MRI显示37例,MIP图31例,MPR图和原始图37例。(3)撕裂口的显示:常规MRI显示23例,MIP不能显示撕裂口,但原始图和MPR图显示31例。(4)真假腔的显示:常规MRI显示37例,MIP图31例,MPR图和原始图37例。结论 3D CE MRA是一种评价主动脉夹层的快速而准确的检查技术。
Objective To investigate the value of three-dimensional contrast-enhanced magnetic resonance angiography (3D CE MRA) in the diagnosis of aortic dissection. Methods Thirty-seven patients with aortic dissection were examined by 3D CE MRA. The maximum signal intensity projection (MIP) and multiplanar reconstruction (MPR) were used for image reconstruction. Enhanced scan anterograde FSE sequence T1WI, T2WI, enhanced transverse line transection FSE T1WI, suspicious tear location Cine sequence. Focus on the classification of aortic dissection, endometrial flaps, tearing mouth and true and false lumen. Results MIP images of 3D CE MRA showed a sensitivity of 84% and a specificity of 100% for the diagnosis of aortic dissection. Combined with original and MPR images, the sensitivity is up to 100%. (1) Type of aortic dissection: type I in 9 cases, accounting for 24.3%; type II in 2 cases, accounting for 5.4%; type II in 26 cases, accounting for 70.3%. (2) the display of endometrial flap: conventional MRI showed 37 cases, 31 cases of MIP, MPR and 37 cases of original. (3) tear the mouth of the show: conventional MRI showed 23 cases, MIP can not show tear, but the original map and MPR showed 31 cases. (4) The display of true and false lumen: conventional MRI showed 37 cases, 31 cases of MIP, MPR and 37 cases of original. Conclusions 3D CE MRA is a rapid and accurate technique for the assessment of aortic dissection.