| Objectives:To investigate the value of ultrasound (US) combined with three dimensional dynamic contrast enhanced magnetic resonance angiography (3D DCE-MRA) in the diagnosis of arteriosclerosis obliterans in lower extremity.Materials and methods :Patients dataA total of 96 individuals from Qilu Hospital,Shandong University were studied during January, 2005 to January, 2007. Ninty-six patients were examined by US and 3D DCE-MRA , and the obtained results were compared with DSA and/ or surgery.Instruments and inspection methods1. It divides the lower limb artery into 8 segments: common femoral artery, superficial femoral artery, profunda femoral artery, anterior tibial artery, anterior tibial artery ,popliteal artery posterior tibial artery and peroneal artery.2. Ultrasound instrument and inspection methodsThe instrument was Logiq7 color Doppler Ultrasound instrument. The type of ultrasound probe were 10L,the frequency of probe was 5-10 MHz. Direct examination of B-mode ultrasound imaging was performed The color Doppler ultrasound and pulsed DW of the lower limb blood flow in 96 patients were examined. Blood vessel inside diameter and mottling existence situation were surveyed by two-dimensional gray scale blood flow image technology (B-flow technology) and two-dimensional gray scale; Colored blood stream signal change were observated by two-dimensional color Doppler flow imaging.3. MRA instrument and inspection methodsA total of 96 patients were detected by 3D DCE-MRA with body coil and move bed technique using 3.0TMR of GE company , and they were injected gadolinium contrast medium through intravenous bolus with the Spectris MR injector of MEDRAD.Imaging process:1. All results of ultrasound record were input the compact disc .2. All the primary graphs were analyzed after the MIP and REFORMAT reconstruction by ADW 4.2 software.Lower limb artery pathological change graduation standard:According to the formula [ (narrow near-end diameter - narrow place diameter)/narrow near-end diameter ]×100%, the computation is narrow rate. It divided the pathological change artery into four levels:mild narrow (narrow rate is smaller than 50%); moderate narrow (narrow rate 50%-70%); the specific weight narrow (narrow rate is bigger than 70%) as well as occlusion.Statistics process:All the analysis procedures were completed through SPSS 10.0 software.The measurement data was indicated by the meanvalue±standard difference that. The difference comparison uses the t examination.Results:1. The ultrasound result(1) B-mode, CDFI and the B-flow technology surveyed 165 normal segment arteries confirmated by DSA, finally indicated that the B-flow technology can accurately surveys the blood vessel inside diameter.(2) 436 segment morbid arteries were discovered in 96 lower limb artery cases. (3) In the narrow blood vessels, the color are obviously gloomy and the low resistance indexes single-phase blood stream frequency spectrum.2. 3D DCE-MRA result(1) All the 3D DCE- MRA angiographies were clearly demonstrated.(2) 96 lower limbs artery cases were discovered 436 lower limbs arteriostenosis .3. A total of 96 lower limbs arteries case were obtained .The accuraces of US and 3D DCE-MRA were 89.9 % and 86.2 % , respectively , while the accuracy of US combined with 3D DCE-MRA was 93.6 %.Conclusions :1. In accurate aspect of the soft mottling demonstration and the blood vessel inside diameter the B-flow technology surpasses two-dimensional supersonic and the colore doppler flow imaging.2. Ultrasonography and three dimensional enhancements magnetic resonance blood vessel imagery technology in observation and survey of the lower limb artery blood vessel graduation and so on, have the same inspection effect as DSA.3. As no wound and the illness complication is few, US combined with 3D DCE-MRA may satisfy the clinical request of the diagnosis lower limb arteriostenosis disease, and easily is accepted by the patient. It will be able to replace the DSA in the certain degree.
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