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非增强磁共振静脉成像技术对盆腔深静脉疾病的诊断价值
沈祖根1,蒋黛蒂1*,范隆华2,刘坚军2
0
(1. 复旦大学附属中山医院青浦分院放射科, 上海 201700;
2. 复旦大学附属中山医院青浦分院血管外科, 上海 201700
*通信作者)
摘要:
目的 探讨非增强磁共振静脉成像(MRV)技术对盆腔深静脉疾病的诊断价值。 目的 选取临床可疑盆腔及下肢静脉疾病患者50例,行下肢血管2D-TOF MRV(two-dimensional time-of-flight MR venography)检查。技术参数:回波时间5~7 ms,重复时间35~45 ms,翻转角35°~45°。检查范围包括下腔静脉下段至腘静脉水平,图像质量经评定分级。MRV检查结果与B超或DSA结果进行对比。 结果 50例患者图像均能清晰显示下腔静脉下段至腘静脉及其分支,图像质量评分结果诊断率达96.0%;其中25例能清晰显示下腔静脉、髂总静脉、髂内外静脉、股总静脉、股深股浅静脉、腘静脉723条,其符合率为96.4%。50例患者中MRV提示9例下腔静脉下段至髂外静脉段血栓形成,而B超检查无法清晰完整显示及诊断。10例患者同时进行DSA检查,9例MRV结果与DSA符合,1例MRV提示髂总静脉起始段血栓者DSA造影显示正常。 结论 MRV诊断盆腔及下肢静脉疾病具有无创、扫描范围大、对比度高、图像准确直观等优点,值得临床推广。
关键词:  下肢静脉  盆腔深静脉  深静脉血栓  磁共振成像  诊断
DOI:10.3724/SP.J.1008.2015.01069
投稿时间:2015-02-05修订日期:2015-06-17
基金项目:上海市青浦区卫生局科研课题(2012-10).
Diagnosis value of non-enhanced magnetic resonance venography for deep pelvic vein disease
SHEN Zu-gen1,JIANG Dai-di1*,FAN Long-hua2,LIU Jian-jun2
(1. Department of Radiology, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700, China;
2. Department of Vascular Surgery, Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700, China
*Corresponding author.)
Abstract:
Objective To evaluate the diagnostic value of non-enhanced magnetic resonance venography (MRV) for deep pelvic vein disease. Methods A total of 50 patients highly suspicious of pelvic and lower extremity vein disease were enrolled in the present study, and they were subjected to lower extremity vascular 2D-TOF MRV(two-dimensional time-of-flight MR venography)examination with the following technical parameter: echo time 5-7 ms, repetition time 35-45 ms, and flip angle 35°-45°. The MRV range included the scanning from low segment of inferior vena cava (IVC) to the popliteal vein (PV); the image quality was scaled into grades, and the results of MRV were compared with those of ultrasound and DSA. Results The images of all 50 patients clearly showed the scanning from low segment of IVC to the PV and its branches, with the diagnostic accuracy reaching 96.0%. The images of 25 patients clearly showed a total of 723 veins, including IVC, common iliac vein (CIV), internal iliac vein, external iliac vein (EIV), common femoral vein, deep femoral vein, superficial femoral vein and PV, with a consistent rate of 96.4%. Thrombosis from inferior segment of IVC to EIV was shown on MRV images of 9 patients, while it could not be clearly and completely manifested by B-ultrasound. Ten patients received DSA simultaneously, and the MRV results of 9 were in accord with those of DSA findings. MRV of one patient with thrombosis at initial segment of CIV was shown normal on DSA. Conclusion MRV for diagnosis of lower extremity vascular lesions has the advantage of non-trauma, greater scanning range, high grade contrast, excellent image delineation and intuitive convincement, making it worth popularizing in clinic.
Key words:  lower extremity veins  deep pelvic veins  deep vein thrombosis  magnetic resonance imaging  diagnosis