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目的探讨下肢深静脉血栓形成磁共振直接成像(magnetic resonance direct thrombus imaging,MRDTI)的临床应用价值。方法对31例临床确诊下肢深静脉血栓形成的患者进行了MRDTI和MRA检查,MRDTI选用SE序列T1WI、FSE序列T2WI、FAST(fourier acquired steady state)序列。其中23例患者做了数字减影血管造影(digital subtraction angiography,DSA)检查。结果急性血栓共23例,血栓在FSE序列T2WI、FAST多为等、高信号表现,信号多不均匀。慢性血栓共8例:血栓在FSE序列T2WI、SE序列T1WI、FAST多为低信号或等信号,3例慢性血栓形成有血管壁增厚、血管壁不规则表现。下肢深静脉血栓形成的MRA表现有:静脉充盈缺损(19例)、静脉闭塞和中断(9例)、静脉再通(4例)、侧枝循环形成(31例)。以DSA为诊断标准,MRA诊断符合率为95.65%。结论对下肢深静脉血栓形成MRDTI检查可作为MRA检查的重要补充。
Objective To investigate the clinical value of magnetic resonance direct thrombus imaging (MRDTI) for the treatment of lower extremity deep venous thrombosis. Methods MRDTI and MRA were performed in 31 clinically diagnosed patients with deep venous thrombosis of the lower extremities. MRDTI was performed on T1WI, T2WI and FAST (fourier acquired steady state) sequences. Twenty-three of these patients underwent digital subtraction angiography (DSA). Results There were 23 cases of acute thromboembolism. The thrombus were mostly of the same or high signal intensity on the FSE sequence T2WI and FAST, and the signals were uneven. Chronic thromboembolism in 8 cases: thrombus in FSE sequence T2WI, SE sequence T1WI, FAST mostly low signal or signal, 3 cases of chronic thrombosis with vascular wall thickening, irregular vascular wall performance. MRA manifestations of deep venous thrombosis of the lower extremities included venous filling defect in 19 cases, venous occlusion and interruption in 9 cases, recanalization in 4 cases and collateral circulation in 31 cases. With DSA as the diagnostic criteria, the coincidence rate of MRA diagnosis was 95.65%. Conclusion MRDTI for deep venous thrombosis of lower extremities can be used as an important complement to MRA.