锁骨下动脉盗血综合征的MRA诊断

MRA in the diagnosis of subclavian steal syndrome

关键词:  磁共振血管造影术  颈动脉狭窄  盗血综合征

Key words:  magnetic resonance angiography  carotid stenosis  subclavian steal syndrome

摘要:

［目的］ 通过PC-MRA、TOF-MRA和CE-MRA对锁骨下动脉盗血综合征诊断的比较分析，探讨综合运用不同方法磁共振血管成像（Magnetic resonance angiography，MRA）技术对锁骨下动脉盗血综合征进行诊断。［方法］ 回顾性分析经DSA检查证实锁骨下动脉盗血综合征患者12例、12处狭窄（右侧4例，左侧8例），所有患者均行PC-MRA、TOF-MRA、CE-MRA和DSA检查。对三种MRA方法对锁骨下动脉盗血综合征的诊断进行比较分析。［结果］ 锁骨下动脉窃血12例患者中，共12处狭窄（无名动脉4处，左侧锁骨下动脉起始部8处）。TOF-MRA对狭窄均未做出定性诊断，未能对窃血做出定性诊断与定量分析；CE-MRA对12处狭窄的定性诊断准确，对狭窄程度判断7例准确，对狭窄长度的诊断10例准确，对8例窃血定性诊断准确，不能对窃血进行定量分析；PC-MRA对所有12例窃血定性诊断准确，并做出定量分析。［结论］ PC-MRA可以对锁骨下动脉窃血进行定性诊断和定量分析；CE-MRA能够对锁骨下动脉狭窄进行定性和定量诊断，可对部分锁骨下动脉窃血进行定性诊断但不能做定量分析，TOF-MRA对锁骨下动脉狭窄诊断能力有限；综合运用PC-MRA和CE-MRA可以对锁骨下动脉狭窄做出全面准确评价。

Abstract:

［Objective］ To detect various kinds of Magnetic Resonance Angiography (MRA) techniques in the diagnosis of subclavian steal syndrome, by comparing PC-MRA, TOF-MRA and CE-MRA. ［Methods］ Twelve patients with subclavian steal syndrome and twelve stenosis sites (4 on the right and 8 on the left) demonstrated by DSA. PC-MRA, TOF-MRA, CE-MRA and DSA were retrospectively analyzed. The three MRA techniques also compared. ［Results］ There were 12 stenosises in the 12 patients (4 in innominate artery and 8 in proximal left subclavian artery). TOF-MRA couldn't provide not only qualitative diagnosis on stenosis, but also qualitative and quantitative diagnosis on blood steal. CE-MRA gave correct qualitative diagnosis on 12 stenosis, accurately assessed the stenosis degree in 7 patients and the stenosis longitude in 10 patients. It also qualitatively diagnosed 8 cases of blood steal but failed for quantitative analysis. PC-MRA correctly diagnosed blood steal in all of 12 cases, both qualitative and quantitative. ［Conclusion］ PC-MRA could provide both qualitative and quantitative diagnosis to subclavian steal syndrome; CE-MRA could provide qualitative and quantitative diagnosis to subclavian stenosis and partial qualitative diagnosis to subclavian steal syndrome but not quantitative diagnosis of it; TOF-MRA is limited in subclavian stenosis. Accurate diagnosis to subclavian stenosis could be done by PC-MRA combined with CE-MRA.