摘要
目的评估前列腺动脉栓塞术(PAE)前行盆腔对比剂增强磁共振血管成像(MRA)识别前列腺动脉的价值。方法本研究为多中心、前瞻性临床研究,收集2016年1月至2018年4月国内5家医院47例PAE前行MRA识别前列腺动脉的良性前列腺增生(BPH)患者,年龄56~83岁,平均(69±16)岁,以DSA或DSA联合锥形术CT明确的前列腺动脉为参照,评估MRA在显示前列腺动脉起源、数目、侧支、敏感度、特异度及最佳投射角度等方面的价值。结果47例患者(94侧盆腔),PAE术中共发现97条前列腺动脉,PAE术前经MRA共识别88条前列腺动脉及起源,识别敏感度为90.7%(88/97),特异度为93.6%(88/94),双侧同时识别率为76.6%(36/47)。PAE术中所有患者参照MRA显示的前列腺动脉最佳投射角度设定球管角度(身体同侧倾斜20°~45°),清楚地显示了前列腺动脉的起源及走形。结论PAE术前行盆腔增强MRA对观察前列腺动脉的起源、走形、数目及侧支敏感度和特异度均较高,对指导PAE具有重要参考价值。
Objective To assess the values of pelvic contrast enhanced magnetic resonance angiography (MRA)in detection of prostatic artery prior to prostatic arterial embolization(PAE).Methods This multicenter,prospective study from 5 hospitals in China consisted of 47 patients (mean age (69±16) years,range 56-83 years)who underwent PAE for benign prostatic hyperplasia (BPH)between January 2016 and April 2018,preprocedural prediction of prostatic arteries were determined using contrast enhanced MRA.CE-MRA findings were compared with subsequent intraprocedural digital subtraction angiography (DSA)or DSA combined with cone-beam computed tomography (CT)to assess the sensitivity and specificity with which contrast enhanced MRA predicted the number and origins of prostatic artery,also to assess the optimal oblique projection of PA.Results In total,47 patients (94 pelvic sides)with 97 PAs confirmed by DSA or DSA combined with cone-beam CT at the time of embolization,MR angiography successfully identified 88 PAs and their origins ,the sensitivity and specificity was 90.7%(88/97) and 93.6%(88/94),respectively.MR angiography correctly determined the bilateral prostatic artery origins in 36(76.6%)cases.According to the optimal oblique projection of PAs suggested by MR angiography,the origins and trajectory of PAs of all patients underwent PAE with the same oblique projection (20°-45° ipsilateral anterior oblique direction )were clearly displayed when performed the first arteriography.Conclusion Pelvic contrast enhanced MR angiography with high sensitivity and specificity in detection the origin,trajectory and number of PAs,and it could provide useful information regarding prostatic arteries before,PAE.
作者
张金龙
王茂强
段峰
叶慧义
申艳光
孙成建
张秀军
李志强
姜文浩
袁凯
Zhang Jinlong;Wang Maoqiang;Duan Feng;Ye Huiyi;Shen Yangnang;Sun Chengjian;Zhang Xiujun;Li Zhiqiang;Jiang Wenhao;Yuan Kai(School of Medicine,Nankai University,Tianjin 300071,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第47期3848-3852,共5页
National Medical Journal of China
基金
国家自然科学基金(81471769)
中央保健科研课题(W2013BJ09)
军队“十二五”重点项目(BWS11J028)
北京市科技新星课题(Z141107001814099).
关键词
前列腺增生
栓塞
治疗性
磁共振成像
Prostatic hyperplasia
Embolization
therapeutic
Magnetic resonance imaging
