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目的探讨先天性膈疝修补术后的2岁儿童行肺部3.0T动态对比增强MRI检查的可行性,以及该检查能否显示可能伴发的肺发育不良(表现为局部微循环减低)。方法选取12个膈疝修补术后儿童[平均年龄(2.0±0.2)岁]进行3.0T动态对比增强MRI检查,采用高时间分辨力的随机投影(TWIST)MRA序列。采用逐体素反卷积方式定量分析肺灌注情况。在避开大的肺内动静脉的情况下,分别选取6个感兴趣区(左右肺的上中下部)来评价肺血流量(PBF)、肺血容量(PBV)和平均通过时间(MTT)的情况。结果膈疝同侧和对侧的PBF和PBV值间的差异均具有统计学意义(P<0.05),而双肺的MTT值则无明显差异(P=0.5)。结论在3T条件下对2岁先天性膈疝修补术后儿童进行动态对比增强MRI检查具有可行性。患侧PBF值明显低于对侧,提示肺灌注减低。先天性膈疝修补术后儿童的肺动态对比增强MRI检查有助于早期确定肺发育不良,并可进行长期随访观察。
Objective To investigate the feasibility of 3.0T dynamic contrast-enhanced MRI in the lungs of 2-year-old children undergoing congenital diaphragmatic hernia repair and whether this test can show hypoplasia of the lungs, which may be accompanied by the reduction of local microcirculation. Methods Thirteen children with diaphragmatic hernia repair (mean age 2.0 ± 0.2 years) were enrolled in 3.0T dynamic contrast-enhanced MRI and MRT sequences with high time-resolved random projection (TWIST). Quantitative analysis of pulmonary perfusion by voxel deconvolution. The six regions of interest (upper and lower left and right lungs) were selected to assess the pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT), respectively, while avoiding large intrapulmonary arteriovenous vessels Case. Results The differences of PBF and PBV between ipsilateral and contralateral to diaphragmatic hernia were statistically significant (P <0.05), while there was no significant difference between two groups (P = 0.5). Conclusions The dynamic contrast-enhanced MRI examination of 3-year-old children undergoing 2-year-old congenital diaphragmatic hernia repair is feasible. Ipsilateral PBF was significantly lower than the contralateral, suggesting decreased lung perfusion. Contrast-enhanced MRI of children with congenital diaphragmatic hernia repair can help determine early lung dysplasia and allow long-term follow-up.