Abstract
目的 通过规范扫描时相、增加三维采集厚度及采用减影后处理技术,评价三维动态增强MR血管成像(3D DCE MRA)对显示门静脉高压症患者侧支循环的作用.方法30例门静脉高压症患者进行3D DCE MRA,其中12例采用75～90 mm的三维采集厚度,扫描时相以呼吸次数粗略估计,采集3～5次,18例采用150～180 mm三维采集厚度,扫描时相以秒表计时确定,分别于0、20、40、60、90 s采集5次.比较减影前后的最大强度投影(MIP)重组图像对门静脉系统血管主干及侧支的显示能力(以4级法评价),并统计患者显示的所有侧支血管及其显示的最佳时间.结果减影技术会降低门静脉主干的显示效果[减影前(2.74±0.31)级,减影后(2.53±0.49)级],差异有统计学意义(t=2.65,P＜0.05),而提高食管胃底曲张静脉的显示[减影前(1.63±0.50)级,减影后(2.58±0.30)级],差异有统计学意义(t=-12.56,P＜0.01).门静脉主干与多数侧支循环为20 s左右显示最佳,个别侧支血管显影延迟.结论采用减影后处理技术能提高对门静脉高压症患者侧支血管的显示,规范的扫描时相不会遗漏显影较晚的侧支循环,增大采集厚度能保证前后腹壁侧支循环的显示。
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