以造影增强磁共振血管成像术诊断先天性主动脉弓畸形

目的评价造影增强磁共振血管成像术（CE-MRA）对先天性主动脉弓畸形的诊断准确性并与超声心动图等比较。方法413例先天性主动脉弓畸形病例在1999年4月到2004年12月期间做了CE-MRA检查。年龄5d～11岁，平均年龄2.4岁。检查使用1.5T磁共振扫描仪。对比剂gadolinium-DTPA，剂量0.2mmol／kg体质量，手动静脉注射。磁共振检查前均已做心脏超声检查。结果在413例中，动脉导管未闭（PDA）166例，主动脉缩窄（COA）168例，主动脉弓中断（IAA）31例，双主动脉弓等其他先天性主动脉弓畸形48例。全部413例均经手术和／或X线心血管造影证实。CE-MRA的诊断准确率为97.3％（402／413），心脏超声检查的诊断准确率为87.2％（360／413）。结论对于先天性主动脉弓畸形，CE-MRA是可靠的影像学检查方法，不仅优于心脏超声检查，有时CE-MRA甚至能比传统的X线心血管造影术提供更多的诊断信息。

Congenital aortic arch anomalies diagnosed by contrast enhancement magnetic resonance angiography

Objective To evaluate the accuracy of contrast-enhanced magnetic resonance angiography(CE-MRA)for the diagnosis of congenital aortic arch anomalies in children,and compare that with transthoracic echocardiography.Methods The CE-MRA was performed for diagnosis of congenital aortic arch anomalies in 413 cases during April 1999 to December 2004.Echocardiography was also performed in all cases.The age of the patients ranged from 5 days to 11 years(mean 2.4 years).Examinations were performed with a 1.5 T MR unit.Gadolinium-DTPA was used as contrast medium with a dose of 0.2 mmol/kg body weight.Results In the 413 cases,there were patent ductus arteriosus(PDA)166,coarctation of aorta(COA)168,interruption of aortic arch(IAA)31,double aortic arch and other congenital aortic arch anomalies 48.The diagnosis in these cases was demonstrated by operation and/or conventional X-ray angiocardiography.The diagnostic accuracy of CE-MRA was 97.3 %(402/413)and the diagnostic accuracy of echocardiography was 87.2 %(360/413).Conclusion It is demonstrated that CE-MRA is a reliable noninvasive imaging diagnostic approach for congenital aortic arch anomalies.Occasionally even more information can be obtained from CE-MRA than conventional X-ray angiocardiography for congenital aortic arch anomalies.Compare with echocardiography,CE-MRA can diagnose congenital aortic arch anomalies more accurately.