MAGNETIC-RESONANCE-IMAGING OF ANGIOGRAPHICALLY OCCULT RUNOFF VESSELS IN PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
MAGNETIC-RESONANCE-IMAGING OF ANGIOGRAPHICALLY OCCULT RUNOFF VESSELS IN PERIPHERAL ARTERIAL OCCLUSIVE DISEASE
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DOI：
10.1056/nejm199206113262428
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发表时间：
1992-06-11
影响因子：
158.5
通讯作者：
COPE, C
中科院分区：
文献类型：
--
作者：
OWEN, RS;CARPENTER, JP;COPE, C
背景 小腿动脉旁路移植术已成为晚期外周血管疾病的标准外科治疗。其成功取决于识别合适的远端血管。术前准备包括小腿动脉成像，通常采用传统的动脉造影。另一种替代方法磁共振（MR）血管造影术已成功应用于各种心血管疾病患者，但其在外周血管疾病患者中的可能价值很少受到关注。我们使用传统的和磁共振血管造影术在术前研究的小腿血管的23例（25条腿）周围动脉硬化和动脉功能不全，并制定独立的治疗计划的基础上提供的信息，由每种技术。当计划不同时，进行了判断更有可能挽救肢体的介入手术。常规和MR血管造影的结果通过术中动脉造影、介入后动脉造影或直接手术探查证实。磁共振血管造影检测到所有的血管识别的传统血管造影，而传统的动脉造影未能检测到22%的径流血管识别的磁共振血管造影。通过MR血管造影检测到常规血管造影无法识别的血管改变了4例患者（17%）的手术治疗，并指导了成功的旁路手术。磁共振血管造影是一种非侵入性技术，在检测外周动脉闭塞性疾病患者的远端流出血管方面，其灵敏度高于传统的动脉造影。
Background. Bypass grafting to arteries of the lower leg has become standard surgical management of advanced peripheral vascular disease. Its success depends on identifying suitable distal vessels. Preoperative preparation includes imaging of the arteries of the lower leg, usually by conventional contrast arteriography. An alternative procedure, magnetic resonance (MR) angiography, has been successfully employed in patients with various cardiovascular diseases, but its possible value in patients with peripheral vascular disease has received little attention.Methods. We used both conventional and MR angiography in preoperative studies of the lower-leg vessels of 23 patients (25 legs) with peripheral arteriosclerosis and arterial insufficiency, and developed independent therapeutic plans based on the information provided by each technique. When the plans differed, the interventional procedure judged more likely to save the limb was performed. The findings of conventional and MR angiography were verified by intraoperative arteriography, postinterventional arteriography, or direct operative exploration.Results. MR angiography detected all vessels identified by conventional angiography, whereas conventional arteriography failed to detect 22 percent of the runoff vessels identified by MR angiography. The detection by MR angiography of vessels not identified by conventional angiography altered the surgical management of the disorders of four patients (17 percent) and guided successful bypass procedures.Conclusions. MR angiography is a noninvasive technique with greater sensitivity than conventional contrast arteriography for detecting distal runoff vessels in patients with peripheral arterial occlusive disease.