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目的:评价基于非对比增强磁共振血管成像(NCE-MRA)技术的优化运动敏感驱动平衡(iMSDE)预备的平衡稳态自由进动(bSSFP)序列在糖尿病患者下肢血管成像中的应用价值。方法:这项前瞻性研究招募了35例Ⅱ型糖尿病患者并在1.5TMR扫描仪上先后进行NCE-MRA和CE-MRA检查;获得的MIP图像由两位放射学医师进行双盲评分并以CE-MRA为参考标准检测NCE-MRA对血管狭窄的诊断精度;两者间血管诊断价值血管段比率的比较采用χ~2检验。结果:NCE-MRA在盆腔段血管中诊断价值血管段比率较CE-MRA降低。两位医师对NCE-MRA组图像的敏感性、特异性、阳性预测值、阴性预测值以及NCE-MRA准确率分别为95%/87%、96%/95%、57%/72%、99%/99%、96%/95%(κ=0.76)。结论:此项基于NCE-MRA技术的iMSDE预备的bSSFP序列可有效的显示糖尿病患者下肢动脉病变,并且具备不使用造影剂、扫描时间短优点以及大腿及小腿段血管具备较好的诊断价值。
OBJECTIVE: To evaluate the value of bSSFP sequence based on non-contrast enhanced magnetic resonance angiography (NCE-MRA) in the optimal motion-sensitive driving balance (iMSDE) preparation for lower extremity vascular imaging in diabetic patients. METHODS: This prospective study enrolled 35 patients with type 2 diabetes mellitus and subsequently performed NCE-MRA and CE-MRA examinations on a 1.5T MRI scanner; the obtained MIP images were double-blindly scored by two radiologists and evaluated with CE MRA was used as a reference standard to detect the diagnostic accuracy of NCE-MRA for vascular stenosis. The comparison of vascular diagnostic value between two groups was performed byχ ~ 2 test. Results: The diagnostic value of NCE-MRA in pelvic vessels was lower than that of CE-MRA. The sensitivity, specificity, positive predictive value, negative predictive value and NCE-MRA accuracy of the two physicians in the NCE-MRA group were 95% / 87%, 96% / 95%, 57% / 72% 99% / 99%, 96% / 95% (κ = 0.76). Conclusion: The iSSDE-based bSSFP sequence based on NCE-MRA technology can effectively display the lower extremity arterial disease in diabetic patients. It also has the advantages of not using contrast agent, short scan time and better diagnostic value of thigh and lower leg blood vessels.