中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2015年
1期
6-10
,共5页
唐鹤菡%李昌宪%袁元%冉兴无
唐鶴菡%李昌憲%袁元%冉興無
당학함%리창헌%원원%염흥무
糖尿病足%磁共振血管造影术%下肢
糖尿病足%磁共振血管造影術%下肢
당뇨병족%자공진혈관조영술%하지
Diabetic foot%Magnetic resonance angiography%Lower extremity
目的 探讨序列优化的下肢MRA诊断糖尿病足的价值.方法 前瞻性纳入临床及常规下肢影像检查未见异常,经超声检查排除下肢动脉病变的28名志愿者,分2次行下肢小腿血管MRI增强扫描,并行采集加速因子(PIF)分别为3、4.测量计算腘动脉、胫后动脉、胫前动脉及腓总动脉的信噪比(SNR)及对比噪声比(CNR),并进行图像质量评分.收集临床确诊的糖尿病足患者20例,同一患者均采用方案1(传统的Care-bolus扫描)和方案2(行优化K空间中心填充的延迟时间扫描)行大腿、小腿及足部的增强MRA扫描.对采用不同扫描方案图像的股动脉、腘动脉、胫后动脉、胫前动脉、腓总动脉、足背动脉、足底内侧动脉及足底外侧动脉进行评分,并对大腿、小腿及足部血管进行静脉重叠评分.采用配对t检验比较志愿者在不同PIF时各部位SNR及CNR的差异;采用Wilcoxon检验比较志愿者在不同PIF时小腿血管显示的差异以及患者采用2种方案扫描对各部位血管的评分和静脉重叠评分的差异.结果 志愿者行小腿MRA,PIF=3时,腘动脉、胫后动脉、腓总动脉的SNR分别为267±84、174±51、147±42,CNR分别为232±83、139±51、108±39;PIF=4时,上述部位的SNR分别为239±73、157±53、132±35,CNR分别为206±71、124±50、103±33,上述部位PIF=3时的SNR及CNR均高于PIF=4时,差异有统计学意义(t值为2.31～4.11,P均＜0.05).PIF为3或4时,上述血管显示评分的差异均无统计学意义(P均＞0.05).20例糖尿病足患者采用方案1行下肢MRA,腘动脉、胫后动脉、胫前动脉、腓总动脉、足背动脉、足底内侧动脉、足底外侧动脉的图像质量评分分别为(3.40±0.82)、(2.70±0.80)、(2.50±1.00)、(2.20±0.77)、(2.30±0.92)、(2.15±1.04)、(1.45±0.60)分,小腿及足部的静脉重叠评分分别为(2.20±1.01)、(2.20±1.06)分;采用方案2上述部位的图像质量评分分别为(3.85±0.37)、(3.55±0.69)、(3.30±0.92)、(2.90±0.79)、(3.30±0.92)、(3.25±0.79)、(1.95±1.10)分,小腿及足部的静脉重叠评分分别为(3.70±0.47)、(3.65±0.49)分,差异均有统计学意义(P均＜0.05),方案2优于方案1.结论 适当提高并行采集加速因子、个性化设置K空间中心填充的延迟时间,有助于提高糖尿病足下肢全程血管的成像质量.
目的 探討序列優化的下肢MRA診斷糖尿病足的價值.方法 前瞻性納入臨床及常規下肢影像檢查未見異常,經超聲檢查排除下肢動脈病變的28名誌願者,分2次行下肢小腿血管MRI增彊掃描,併行採集加速因子(PIF)分彆為3、4.測量計算腘動脈、脛後動脈、脛前動脈及腓總動脈的信譟比(SNR)及對比譟聲比(CNR),併進行圖像質量評分.收集臨床確診的糖尿病足患者20例,同一患者均採用方案1(傳統的Care-bolus掃描)和方案2(行優化K空間中心填充的延遲時間掃描)行大腿、小腿及足部的增彊MRA掃描.對採用不同掃描方案圖像的股動脈、腘動脈、脛後動脈、脛前動脈、腓總動脈、足揹動脈、足底內側動脈及足底外側動脈進行評分,併對大腿、小腿及足部血管進行靜脈重疊評分.採用配對t檢驗比較誌願者在不同PIF時各部位SNR及CNR的差異;採用Wilcoxon檢驗比較誌願者在不同PIF時小腿血管顯示的差異以及患者採用2種方案掃描對各部位血管的評分和靜脈重疊評分的差異.結果 誌願者行小腿MRA,PIF=3時,腘動脈、脛後動脈、腓總動脈的SNR分彆為267±84、174±51、147±42,CNR分彆為232±83、139±51、108±39;PIF=4時,上述部位的SNR分彆為239±73、157±53、132±35,CNR分彆為206±71、124±50、103±33,上述部位PIF=3時的SNR及CNR均高于PIF=4時,差異有統計學意義(t值為2.31～4.11,P均＜0.05).PIF為3或4時,上述血管顯示評分的差異均無統計學意義(P均＞0.05).20例糖尿病足患者採用方案1行下肢MRA,腘動脈、脛後動脈、脛前動脈、腓總動脈、足揹動脈、足底內側動脈、足底外側動脈的圖像質量評分分彆為(3.40±0.82)、(2.70±0.80)、(2.50±1.00)、(2.20±0.77)、(2.30±0.92)、(2.15±1.04)、(1.45±0.60)分,小腿及足部的靜脈重疊評分分彆為(2.20±1.01)、(2.20±1.06)分;採用方案2上述部位的圖像質量評分分彆為(3.85±0.37)、(3.55±0.69)、(3.30±0.92)、(2.90±0.79)、(3.30±0.92)、(3.25±0.79)、(1.95±1.10)分,小腿及足部的靜脈重疊評分分彆為(3.70±0.47)、(3.65±0.49)分,差異均有統計學意義(P均＜0.05),方案2優于方案1.結論 適噹提高併行採集加速因子、箇性化設置K空間中心填充的延遲時間,有助于提高糖尿病足下肢全程血管的成像質量.
목적 탐토서렬우화적하지MRA진단당뇨병족적개치.방법 전첨성납입림상급상규하지영상검사미견이상,경초성검사배제하지동맥병변적28명지원자,분2차행하지소퇴혈관MRI증강소묘,병행채집가속인자(PIF)분별위3、4.측량계산객동맥、경후동맥、경전동맥급비총동맥적신조비(SNR)급대비조성비(CNR),병진행도상질량평분.수집림상학진적당뇨병족환자20례,동일환자균채용방안1(전통적Care-bolus소묘)화방안2(행우화K공간중심전충적연지시간소묘)행대퇴、소퇴급족부적증강MRA소묘.대채용불동소묘방안도상적고동맥、객동맥、경후동맥、경전동맥、비총동맥、족배동맥、족저내측동맥급족저외측동맥진행평분,병대대퇴、소퇴급족부혈관진행정맥중첩평분.채용배대t검험비교지원자재불동PIF시각부위SNR급CNR적차이;채용Wilcoxon검험비교지원자재불동PIF시소퇴혈관현시적차이이급환자채용2충방안소묘대각부위혈관적평분화정맥중첩평분적차이.결과 지원자행소퇴MRA,PIF=3시,객동맥、경후동맥、비총동맥적SNR분별위267±84、174±51、147±42,CNR분별위232±83、139±51、108±39;PIF=4시,상술부위적SNR분별위239±73、157±53、132±35,CNR분별위206±71、124±50、103±33,상술부위PIF=3시적SNR급CNR균고우PIF=4시,차이유통계학의의(t치위2.31～4.11,P균＜0.05).PIF위3혹4시,상술혈관현시평분적차이균무통계학의의(P균＞0.05).20례당뇨병족환자채용방안1행하지MRA,객동맥、경후동맥、경전동맥、비총동맥、족배동맥、족저내측동맥、족저외측동맥적도상질량평분분별위(3.40±0.82)、(2.70±0.80)、(2.50±1.00)、(2.20±0.77)、(2.30±0.92)、(2.15±1.04)、(1.45±0.60)분,소퇴급족부적정맥중첩평분분별위(2.20±1.01)、(2.20±1.06)분;채용방안2상술부위적도상질량평분분별위(3.85±0.37)、(3.55±0.69)、(3.30±0.92)、(2.90±0.79)、(3.30±0.92)、(3.25±0.79)、(1.95±1.10)분,소퇴급족부적정맥중첩평분분별위(3.70±0.47)、(3.65±0.49)분,차이균유통계학의의(P균＜0.05),방안2우우방안1.결론 괄당제고병행채집가속인자、개성화설치K공간중심전충적연지시간,유조우제고당뇨병족하지전정혈관적성상질량.
Objective To explore the optimal protocol of lower-extremity contrast-enhanced MRA (CE-MRA) in the evaluation of diabetic foot.Methods Twenty eight healthy volunteers were scanned by CE-MRA in crus twice with parellel imaging factor (PIF) of 3 or 4.The signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) and image quality of popliteal artery,posterior tibial artery,anterior tibial artery and peroneal artery were compared.Twenty patients with diabetic foot underwent CE-MRA by both of protocol 1 and 2 in leg,crus and foot.Protocol 1 was the traditional Care-bolus protocol and protocol 2 was the optimized K-space center filling delay-time protocol.The difference of two protocols in venous aliasing and in display of femoral artery,popliteal artery,posterior tibial artery,anterior tibial artery,peroneal artery,dorsalis pedis artery,medial plantar artery and lateral plantar artery were compared.The SNR,CNR of two different PIF sequences were compared by paired t test,and the display of artery of crus was compared by Wilcoxon.The display of vessels and venous aliasing of 2 protocols of diabetic foot patients were compared by Wilcoxon.Results In the images of healthy volunteers with PIF of 3,the SNR were 267±84,174±51,147±42;and the CNR were 232 ±83,139±51,108±39 at popliteal artery,posterior tibial artery and peroneal artery.However,in the images with PIF of 4,the SNR were 239±73,157±53,132±35;and CNR were 206±71,124±50,103±33,respectively.Both the SNR and CNR were higher in the former than in the latter(t values were 2.31 to 4.11,P＜0.05).There was no significant difference in the vessel display between the different PIF volunteers (P＞0.05).In the protocol 1 of patients with diabetic foot,the display of popliteal artery,posterior tibial artery,anterior tibial artery,peroneal artery,dorsalis pedis artery,medial plantar artery and lateral plantar artery,the venous aliasing in crus and foot were 3.40±0.82,2.70±0.80,2.50±1.00,2.20±0.77,2.30±0.92,2.15± 1.04,1.45±0.60,2.20± 1.01,2.20± 1.06.And in the protocol 2,they were 3.85±0.37,3.55± 0.69,3.30±0.92,2.90±0.79,3.30±0.92,3.25±0.79,1.95±1.10,3.70±0.47,3.65±0.49,respectively(P＜0.05).All of these parameters of protocol 2 were superior to protocol 1.Conclusion Using a higher PIF properly,setting the personalized K-space center filling delay-time can contribute to improving the image quality of whole lower-extremity MRA in patients with diabetic foot.
