脑发育性静脉异常的CT、MRI诊断.docVIP

脑发育性静脉异常的CT、MRI诊断 作者：马永华 许守利 孙建刚 刘华 张荣坤 【摘要】 目的 探讨脑发育性静脉异常的CT、MRI表现，提高影像学诊断水平。方法 搜集经病理及DSA证实的DVA 38例，7例手术病理证实，31例DSA证实，全部病例均行MRI平扫及增强扫描，8例行CT检查，回顾性分析其CT、MRI表现。 结果 发生于幕下11例，幕上27例。8例行CT检查中，4例平扫未见明显异常密度灶，2例可见右侧小脑半球出血灶，1例右侧额叶见高低密度混杂病灶。1例增强扫描见右侧额叶条纹状异常增强血管影及粗大的引流血管相连。MR扫描显示清晰，T1WI、T2WI表现为条状血管流空影32例，并发海绵状血管瘤5例，表现为不均匀短T1长T2异常混杂信号。 增强扫描显示明显强化的髓静脉及引流静脉，呈典型“水母头”状。幕下DVA引流静脉汇入脑表面静脉者4例，汇入第四脑室的室管膜下静脉7例，幕上DVA引流静脉经皮层静脉汇入脑表面静脉窦者15例，汇入室管膜下静脉者12例，即汇入脑表面静脉又汇入脑深静脉者1例。 结论 CT诊断对该病特异性较小，MRI增强扫描多方位观察，可清楚显示DVA的典型表现，MR检查可完全替代DSA成为DVA首选及确诊检查手段。 【关键词】 脑;发育性静脉异常;　体层摄影术;X线计算机;　磁共振成像 [Abstract] Objective To explore the brain developmental venous anomaly of the CT, MRI performance and improve the level of imaging diagnosis. Methods DSA collected by pathology and DVA 38 confirmed cases, seven cases of surgically and pathologically confirmed DSA confirmed 31 cases, all cases underwent plain and enhanced MRI scan, 8 of routine CT examination, their retrospective analysis of CT, MRI performance. Results Occurred in 11 cases of the next screen, 27 cases of supratentorial. 8 cases CT examination, four cases of abnormal CT density had no obvious lesions, 2 cases of hemorrhage can be seen the right cerebellar hemisphere lesions, one cases of the right frontal lobe lesions, see high-density mixed. 1 cases of CT-like stripes see the right frontal lobe abnormal vascular shadow to enhance drainage and large blood vessels connected. MR scan revealed a clear, T1WI,T2WI showed vascular flow void film strip 32 cases, complicated by cavernous hemangioma of five cases, showed a short T1 uneven mixing length abnormal T2 signal. Significantly enhanced CT shows medullary veins and the venous drainage, showing a typical“medusa head”shape. DVA under the screen into the cerebral venous drainage from the surface of four cases of vein, into the fourth ventricle subependymal veins in 7 cases, supratentorial DVA draining veins into the brain by the cortical vein from the surface of 15 cases of