Hemodynamically significant atherosclerotic renal artery stenosis: MR angiographic features
Hemodynamically significant atherosclerotic renal artery stenosis: MR angiographic features
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DOI：
10.1148/radiology.205.1.9314974
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发表时间：
1997-10-01
期刊：
影响因子：
19.7
通讯作者：
Stanley, JC
中科院分区：
文献类型：
--
作者：
Prince, MR;Schoenberg, SO;Stanley, JC
目得：确定磁共振（MR）血管造影的特点，血流动力学显着的renal arterial stenosis.MATERIALS AND METHODS：47例患者进行了MR血管造影的肾动脉，包括T1加权自旋回波和三维钆增强破坏梯度回波和三维相位对比脉冲序列，其次是肾血管重建。确定了35例患者（52支动脉）受益于肾血运重建，这表明他们有血流动力学显著的肾动脉狭窄。测量肾脏长度、皮质厚度、实质强化和狭窄后扩张，并检查动脉信号丢失相位对比血管造影片上的失相;如果狭窄动脉在相位对比血管造影片上显示闭塞，则认为失相严重。在52例血流动力学显著性肾动脉狭窄中，36例（59%）存在大于20%的狭窄后扩张，52例中有45例（87%）出现严重失相。在单侧血流动力学显著狭窄或闭塞的患者中，平均缺血肾脏长度减少至9.3 cm，而对侧正常肾脏为10.7 cm（P = 0.009），平均实质厚度减少（1.2 vs 1.7 cm; P <0.001），平均实质增强比缺血侧低15%（P = 0.05）。12例单侧肾动脉狭窄患者中有9例（75%）出现严重的相位差，而对侧正常肾动脉仅1例（P <0.001）。结论：MR血管造影显示了肾动脉狭窄的特征，是血流动力学意义的标志。
PURPOSE: To identify magnetic resonance (MR) angiographic features of hemodynamically significant renal artery stenosis.MATERIALS AND METHODS: Forty-seven patients underwent MR angiography of the renal arteries, including T1-weighted spin-echo and three-dimensional gadolinium-enhanced spoiled gradient-echo and three-dimensional phase-contrast pulse sequences, followed by renal revascularization. Thirty-five patients (52 arteries) were identified who benefited from renal revascularization, which indicated that they had hemodynamically significant renal artery stenoses. Kidney length, cortical thickness, parenchymal enhancement, and poststenotic dilatation were measured, Arteries were also examined for signal drop-out (dephasing) on phase-contrast angiograms; dephasing was considered severe if the stenotic artery appeared occluded on phase-contrast angiograms.RESULTS: Poststenotic dilatation of greater than 20% was present in 36 (59%) of 52 hemodynamically significant renal artery stenoses, and severe dephasing was present in 45 (87%) of 52. In patients with unilateral hemodynamically significant stenosis or occlusion, mean ischemic kidney length was reduced to 9.3 cm compared with 10.7 cm for the contralateral normal kidney (P = .009), mean parenchymal thickness was reduced (1.2 vs 1.7 cm; P < .001), and mean parenchymal enhancement was 15% less an the ischemic side (P = .05). Severe dephasing on phase-contrast angiograms was present in nine (75%) of 12 unilateral hemodynamically significant stenoses but in only one contralateral normal renal artery (P < .001).CONCLUSION: MR angiography depicts features of renal artery stenosis that are markers of hemodynamic significance.