Objective To explore the application value of time of flight magnetic resonance angiography (TOF-MRA) in target bypass surgery for moyamoya disease. Methods The data of patients with moyamoya disease in Affiliated Drum Tower Hospital, Medical College, Nanjing University between May 1 and August 30, 2020 were retrospectively analyzed. Patients were divided into navigation group and control group according to whether navigation technology was used during operation. All patients completed TOF-MRA evaluation before operation, and all patients completed surgical treatment. One week after operation, TOF-MRA was reviewed to evaluate the patency of anastomotic stoma. The intraoperative and postoperative conditions of the two groups were compared. Results Finally, 48 patients with moyamoya disease were included. 22 patients who used intraoperative navigation were included in the navigation group, and 26 patients with moyamoya disease who did not use intraoperative navigation in the same period were included in the control group. There was no significant difference between the two groups in gender, age, Suzuki stage before operation, proportion of posterior circulation involvement, proportion of bleeding type, proportion of hypertension and proportion of diabetes (P>0.05). The operation duration [(3.3±0.4) vs. (3.6±0.6) h] and postoperative hospital stay [(7.3±1.9) vs. (8.8±2.7) d] in the navigation group were shorter than those in the control group (P<0.05). There was no significant difference between the two groups in the proportion of patients who completed bypass surgery, the proportion of middle meningeal artery retained, the postoperative patency rate, the proportion of temporary dysfunction, and the proportion of serious complications (P>0.05). Conclusion TOF-MRA sequence combined with navigation technology can effectively guide the surgical scheme design and postoperative evaluation of moyamoya disease.
目的 提高對創傷性假性動脈瘤并動靜脈瘺的影像診斷水平。 方法 報告1例腰椎間盤手術所致的創傷性假性動脈瘤并動靜脈瘺，比較分析MRA和DSA對該病的診斷價值。 結果 MRA能夠明確創傷性假性動脈瘤及動靜脈瘺的診斷，與DSA有良好的相關性。 結論 MRA對創傷性假性動脈瘤并動靜脈瘺的確診有重要價值，在一定程度上能夠代替常規血管造影。
ObjectiveTo explore the value of gadobutrol enhanced magnetic resonance angiography (MRA) in abdominal artery angiography.MethodsThe patients were prospectively included for gadobutrol enhanced MRA examination from December 2014 to December 2015. The image quality was assessed by two radiologists. The subjective score and signal intensity were measured for the large and medium arteries, and the subjective score for the small artery was recorded. The Kappa consistency analysis was used to assess the two radiologists’ subjective score.ResultsAll 112 patients were enrolled in this study, 96 of whom were included for the physical examination, 16 of whom were included for the liver tumors. No adverse reactions were found in these patients. The MRA images of 2 patients were affected by the severe respiratory artifact. The MRA images of the other 110 cases were clear and could well show the origins, shapes of large and medium arteries and small arteries. The subjective scores were 21.22±1.93 and 6.24±1.33 of the large and medium arteries and small arteries, respectively. The values of signal noise ratio and contrast signal noise ratio of the large and medium arteries were 1 093.27±331.71 and 897.27±333.29, respectively. The Kappa values of the two radiologists’ subjective score were 0.782 and 0.772 for the large and medium arteries and small arteries, respectively.ConclusionsGadobutrol enhanced MRA can clearly display large and medium arteries, and can also display some small arteries. It has a good application value in abdominal artery angiography.
目的 探討常規注射速率下單倍劑量對比劑在頸部三維對比增強磁共振血管成像（3D-CEMRA）中的可行性及臨床應用價值。 方法 2011年8月－11月，連續納入30例臨床懷疑頸動脈或椎動脈狹窄并要求頸部磁共振血管成像檢查的患者，隨機分成A、B兩組（每組各15例）。使用西門子Magnetom Avanto 1.5 T磁共振成像儀及其配備的頸部線圈和頭部線圈進行CEMRA成像。A組使用雙倍劑量對比劑（0.2 mmol/kg），B組使用單倍劑量對比劑（0.1 mmol/kg）。用三維快速小角度激發序列進行頸部血管成像。由2位有豐富經驗的高年資醫生對兩組原始圖像的信噪比以及最大密度投影（MIP）圖像的質量進行評價，并對結果進行統計學分析和處理。 結果 A、B兩組的所頸動脈信噪比分別為189.95 ± 71.31、175.07 ± 68.61，差異無統計學意義（t=?0.566，P=0.576）；所得的MIP圖像質量均達到優良，差異無統計意義（χ2=0.180，P=0.671）。 結論 與雙倍劑量相比，單倍劑量對比劑獲得頸部血管的圖像清晰，能夠滿足臨床診斷要求。