目的探讨流入反转恢复（IFIR）序列肾动脉磁共振血管成像（MRA）评估肾动脉狭窄的可行性与可靠性。资料与方法对62例拟诊为肾动脉狭窄患者同时行IFIR与对比增强MRA（CE-MRA）检查，观察肾动脉显示情况，测量肾动脉狭窄率并进行分级，比较IFIR与CE-MRA在诊断肾动脉狭窄方面的差异。结果62例患者共获得148支肾动脉（含副肾动脉），IFIR图像质量好、中、差分别为113支（76.4%）、20支（13.5%）、15支（10.1%）；CE-MRA图像质量好、中、差分别为123支（83.1%）、11支（7.4%）、14支（9.5%），其中141支肾动脉图像能进行狭窄率测量，IFIR与CE-MRA测得狭窄率为0、1、2、3级的肾动脉分别为104支、18支、14支、5支和103支、22支、9支、7支，二者诊断肾动脉狭窄一致性较好（r=0.843, P<0.01）。IFIR对于CE-MRA的灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为81.2%、95.2%、93.6%、68.4%及97.5%。结论IFIR序列MRA在评估肾动脉狭窄率方面与CE-MRA具有较好的一致性，可作为肾功能不全患者肾动脉狭窄的诊断方法。%Purpose To evaluate the feasibility and reliability of non-contrast-enhanced in-flow inversion recovery (IFIR) magnetic resonance angiography (MRA) for detection of renal artery stenosis , with breath-hold contrast–enhanced MRA (CE-MRA) as the reference standard. Materials and Methods Sixty-two patients suspected of renal artery stenosis underwent both IFIR-MRA and CE-MRA. The imaging quality and the stenosis of both techniques were assessed and compared. Results 148 renal arteries (including accessory renal arteries) were displayed by both IFIR-MRA and CE-MRA. The imaging quality of IFIR-MRA was excellent 113 (76.4%), good 20 (13.5%) and poor 15 (10.1%), while the CE-MRA were excellent 123 (83.1%), good 11 (7.4%) and poor 14 (9.5%). The stenosis on 141 vessels could be measured. In a 0-3 stenosis grading system, the IFIR-MRA were 104, 18, 14, 5 and CE-MRA were 103, 22, 9, 7, respectively, showing good correlation (r=0.843, P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of IFIR for renal stenosis detection were 81.2%, 95.2%, 93.6%, 68.4% and 97.5%, respectively with CE-MRA as reference. Conclusion The non-contrast-enhanced IFIR MRA is well consistent with the CE-MRA in renal stenosis detection and can be an alternative to CE-MRA.
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