Pulmonary sequestration: three dimensional dynamic contrast-enhanced MR angiography and MRI.

H Xu, D Jiang, X Kong, Y Xiong, D Liu, X Liu, X Deng
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Abstract

In order to evaluate the diagnostic value of three-dimensional contrast-enhanced MR angiography and MRI for pulmonary sequestration, 5 patients with pulmonary sequestration underwent 3D fast imaging by steady state precession (FISP) with a contrast medium and breath holding following chest radiography, CT and MR scans. The reconstructed MR angiography was performed using maximum intensity projection (MIP) and multiplanar reconstruction (MPR) techniques. It was found that the chest radiography showed pulmonary sequestration as a persistent area of opacity in the posterior basal segment of the left lower lobe, which was close to mediastinum in 2 cases and close to diaphragma in 3 cases. CT revealed a soft issue mass beyond descending aorta and lobar emphysema around the pulmonary sequestration. And the supplying vessel was documented in 2 cases on enhanced CT. MRI demonstrated a hyperintensity mass with respect to normal lung parenchyma on T1WI and T2WI, and the origin of the supplying vessel in 3 cases. The reconstructed CE MRA using MIP or MRP techniques clearly showed the supplying vessel and its course, branches as well as draining vessels. It was concluded that 3D CE MRA of demonstrating the supplying and draining vessels to pulmonary sequestration, together with plain MRI, can provide a diagnosis and aid in surgical planning without the need for DSA.

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肺部嵌塞:三维动态对比增强磁共振血管造影和磁共振成像。
为了评估三维造影剂增强磁共振血管造影和磁共振成像对肺动脉栓塞的诊断价值,5 名肺动脉栓塞患者在接受胸片、CT 和磁共振扫描后,使用造影剂和屏气进行了三维快速稳态前移成像(FISP)。利用最大强度投影(MIP)和多平面重建(MPR)技术对磁共振血管造影进行了重建。结果发现,胸片显示左下叶后基底段有持续性肺不张,其中 2 例接近纵隔,3 例接近膈肌。CT 显示降主动脉外有一软组织肿块,肺栓塞周围有肺叶气肿。2 例病例的增强 CT 显示了供血血管。核磁共振成像在 T1WI 和 T2WI 上显示出相对于正常肺实质的高密度肿块,并在 3 个病例中显示出供血血管的起源。使用 MIP 或 MRP 技术重建的 CE MRA 可清晰显示供血血管及其走向、分支和引流血管。结论是,三维 CE MRA 显示肺动脉栓塞的供血血管和引流血管,再加上普通 MRI,可以提供诊断并帮助制定手术计划,而无需进行 DSA。
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