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目的 探讨增强MR数字减影血管造影检查 (MRDSA)在四肢肌骨系统疾病应用中的技术问题。材料与方法 对 13例肌骨系统疾病患者行常规MRI扫描之后 ,行MRDSA检查。MRDSA采用三维稳态破坏性梯度回返采集 (three dimensionalspoiledgradientrecalledacquisitioninsteadystate,3D SPGR)序列进行扫描 ,扫描参数为 :TR 10 .3ms或 12 .5ms ,TE 1.9ms或 2 .8ms ;翻转角 3 0° ,层厚 1～3mm ,视野 2 8mm× 2 1mm～ 48mm× 3 6mm ;矩阵 2 5 6× 12 8,激励 1次 ,扫描时间 3 2秒。原始图像经过减影处理后再经最大信号强度投影 (MIP)重建。结果 13例中 ,上肢 2例 ,下肢 11例。软组织恶性肿瘤 2例 ,血管性疾病 6例 ,良性骨肿瘤 3例 ,恶性骨肿瘤 2例。混合型血管瘤 4例 ,MRDSA清楚显示供血动脉 3例 ;2例皮下小的海绵状血管瘤未显供血来源 ,但因其基本与动脉同期强化 ,对诊断很有帮助。 1例软组织内恶性纤维组织细胞瘤清楚显示动脉受压及多条肿瘤动脉供血。结论 MRDSA具有扫描时间短、成像质量高、信息量大等优点 ,在肢体疾病的诊断应用中将大有作为。
Objective To explore the technical problems of enhanced MR digital subtraction angiography (MRDSA) in the application of musculoskeletal diseases of limbs. Materials and Methods 13 cases of musculoskeletal disease patients underwent routine MRI scans, MRDSA examination. The MRDSA was scanned using a three-dimensional steady-state destructive gradient recovery (3D SPGR) sequence with a scan parameter of TR 10.3 ms or 12.5 ms, TE 1.9 ms or 2.8 ms, flip angle of 30 °, layer thickness 1 ~ 3mm, field of view 2 8mm × 2 1mm ~ 48mm × 36mm; matrix 256 × 12 8, excitation time 1, scan time 32 seconds. The original image is subtracted and then reconstructed by Maximum Signal Intensity Projection (MIP). Results In 13 cases, 2 cases of upper limbs and 11 cases of lower limbs. 2 cases of soft tissue malignancies, 6 cases of vascular diseases, 3 cases of benign bone tumors, 2 cases of malignant bone tumors. 4 cases of mixed hemangiomas, MRDSA clearly shows that the feeding artery in 3 cases; 2 cases of subcutaneous small cavernous hemangioma is not a source of blood supply, but because of its basic and arterial enhancement over the same period, the diagnosis is very helpful. One case of soft tissue malignant fibrous histiocytoma clearly showed arterial compression and multiple tumor arterial blood supply. Conclusion MRDSA has the advantages of short scanning time, high imaging quality and large amount of information, and will be helpful in the diagnosis and application of limb diseases.