CAJ | 학술논문

目的初步探讨基于血流敏感散相（FSD）和平衡稳态自由进动（SSFP）的非增强磁共振血管成像（NCE-MRA）技术在显示类风湿性关节炎患者手动脉的临床应用价值。资料与方法22例类风湿性关节炎患者采用1.5T成像系统进行手动脉NCE-MRA和增强磁共振血管成像（CE-MRA）检查。对手动脉（划分为腕部、掌部和指部3个血管节段）的图像质量进行评分，并对图像信噪比（SNR）、对比度噪声比（CNR）和血管边缘锐利度进行测量。将NCE-MRA和CE-MRA的图像质量和测量值进行统计学比较。结果22例患者24只手均成功完成NCE-MRA和动态CE-MRA检查。72个血管节段中，NCE-MRA有69个动脉节段的图像质量具有诊断意义，明显高于CE-MRA（96%比83%，P<0.05）。此外，NCE-MRA在手动脉各个部位的图像质量以及SNR、CNR和血管锐利度均优于CE-MRA（P<0.05）。结论 NCE-MRA能清楚地显示手动脉的各个分支，图像质量优于动态CE-MRA，对手动脉病变的诊断具有较好的临床应用潜力。
목적초보탐토기우혈류민감산상（FSD）화평형은태자유진동（SSFP）적비증강자공진혈관성상（NCE-MRA）기술재현시류풍습성관절염환자수동맥적림상응용개치。자료여방법22례류풍습성관절염환자채용1.5T성상계통진행수동맥NCE-MRA화증강자공진혈관성상（CE-MRA）검사。대수동맥（화분위완부、장부화지부3개혈관절단）적도상질량진행평분，병대도상신조비（SNR）、대비도조성비（CNR）화혈관변연예리도진행측량。장NCE-MRA화CE-MRA적도상질량화측량치진행통계학비교。결과22례환자24지수균성공완성NCE-MRA화동태CE-MRA검사。72개혈관절단중，NCE-MRA유69개동맥절단적도상질량구유진단의의，명현고우CE-MRA（96%비83%，P<0.05）。차외，NCE-MRA재수동맥각개부위적도상질량이급SNR、CNR화혈관예리도균우우CE-MRA（P<0.05）。결론 NCE-MRA능청초지현시수동맥적각개분지，도상질량우우동태CE-MRA，대수동맥병변적진단구유교호적림상응용잠력。
Purpose To assess the clinical application of non-contrast-enhanced MR angiography (NCE-MRA) using flow sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for displaying hand arteries of patients with rheumatoid arthritis. Materials and Methods Twenty-two patients with rheumatoid arthritis were recruited in this study. All the patients undertook hand NCE-MRA and three-dimensional dynamic CE-MRA on a 1.5T MR scanner. The informed consent was obtained from each subject. Image quality was assessed independently by two experienced radiologists at three arterial segments (wrist arteries, palm arteries, andfinger arteries) with a four-point scale. Signal to noise ratio (SNR), contrast to noise ratio (CNR), and vessel sharpness were evaluated by a magnetic resonance physicist. The results and image quality were statistically compared between the two MRA techniques.Results Twenty-two patients of 24 hands successfully underwent NCE-MRA and CE-MRA scan. Among 72 vascular segments, 69 segments of NCE-MRA were diagnostic, which was higher than that of CE-MRA (96% vs 83%,P<0.05). Otherwise, the image quality, SNR, CNR and vessel sharpness of NCE-MRA were all superior to those of CE-MRA (P<0.05).Conclusion NCE-MRA using FSD-prepared SSFP allows clear depiction of the hand arterial tree, and the image quality is superior to that of dynamic CE-MRA. It is a potential tool for evaluating the disease of hand arteries.