磁敏感加权成像在颅脑发育性静脉畸形中的诊断价值.docVIP

磁敏感加权成像在颅脑发育性静脉畸形中的诊断价值 　　【摘要】 目的：探讨磁敏感加权成像（SWI）在脑发育性静脉畸形（DVA）中的诊断价值。方法：回顾分析20例脑静脉性血管畸形患者的SWI表现，并与常规MRI检查进行对比分析。结果：20例DVA患者中，19例单发病灶，1例多发病灶。其中位于额叶9例，小脑半球5例，额顶叶2例，顶叶2例，颞叶1例。20例患者中MRI平扫显示9例DVA病灶，呈条状流空信号影；13例MRI增强扫描显示9个病灶，表现为明显线样或“海蛇头”样强化。所有病例在SWI上均显示清晰，呈“海蛇头”样低信号表现。结论：SWI能清晰显示DVA，可取代MR常规检查用于DVA的诊断。 　　【关键词】 脑； 静脉畸形； 磁共振成像 　　中图分类号 R445.2 文献标识码 B 文章编号 1674-6805（2016）5-0064-02 　　【Abstract】 Objective：To discuss the value of MR susceptibility weighted imaging（SWI） in the diagnosis of cerebral developmental venous anomaly（DVA）.Method：The SWI features of 20 patients with cerebral venous malformation were analyzed retrospectively.The SWI images were compared with conventional MRI.Result：All the patients performed conventional sequences，contrast enhanced MRI scanning and SWI sequences examination.Solitary lesion were revealed in 19 out of 20 cases，while 1 case had multiple lesions.The lesions were located in the white matter of frontal lobe（9 lesions），cerebellar hemispheres（5 lesions），white matter of frontal and parietal lobe（2 lesions），white mater of parietal lobes（2 lesions），temporal lobes（1 lesion） respectively.Only 9 lesions were detected by pre-contrast MRI，which demonstrated as linear flow void on T1WI and T2WI.On contrast-enhanced MR imaging in 13 cases，the lesions showed obvious linear enhancement and typical“caput medusae”-like enhancement.On SWI，all the lesions showed typical“caput medusae”-like low signal intensity.Conclusion：SWI can clearly display DVA and be a substitutive modality for contrast-enhanced MR imaging in the diagnosis and follow-up of DVA. 　　【Key words】 Brain； Venous anomaly； Magnetic resonance imaging 　　First-author’s address：Yanshan People’s Hospital，Yanshan 663100，China 　　doi：10.14033/ki.cfmr.2016.5.033 　　随着磁敏感加权成像（susceptibility weighted imaging，SWI）的应用，脑发育性静脉异常（developmental venous anomaly，DVA）检出率越来越高。脑血管畸形分型分为脑发育性静脉异常、动静脉畸形、毛细血管畸形（毛细血管扩张症）、海绵状畸形和混合型脑血管畸形[1-2]。其中DVA是脑血管畸形中最常见的类型，又称为静脉血管瘤、脑发育性静脉异常，约占60%[3]，尸检发生率最高可能达2.5%[4-5]。患者往往无明显的临床