脑深部静脉和颈内静脉改变与多发性硬化的相关性研究.docVIP

脑深部静脉和颈内静脉改变与多发性硬化的相关性研究 曾 春, 李咏梅, 欧阳羽, 罗天友, 吕发金, 陈 璇, 王忠平, 侯焕新(400016 重庆, 重庆医科大学附属第一医院放射科) [摘要] 目的 探讨脑内深部髓质静脉（deep medullary veins，DMVs）特征表现和颈内静脉（internal jugular veins，IJVs）改变与多发性硬化（multiple sclerosis，MS）的关系。方法 对30例复发缓解型MS患者和30例年龄、性别匹配的非MS对照组行常规磁共振成像（magnetic resonance imaging ，MRI）、三维增强T2*加权血管成像（3-dimensional enhanced T2*-weighted angiography，3-D ESWAN）和3-D时间分辨率对比剂动力成像（time-resolved imaging of contrast kinetics，TRICKs）扫描。观察患者和对照组侧脑室体旁DMVs在3-D ESWAN改变并评分；比较患者与对照组DMVs评分和IJVs狭窄发生率的差异，并评价DMVs和IJVs改变分别与EDSS评分和病程的相关性。结果 ① MS患者DMVs评分（1.67 ± 0.25）较对照组（3.00 ± 0.00）显著降低（P＜0.01）；16例病程＞2.0 年者为1分，8例病程0.5～2.0年者为2分，二者与对照组比较差异均有统计学意义（P＜0.01），6例病程＜0.5年者与对照组无显著统计学差异（P＞0.05）。9个慢性病灶“穿通静脉”扩张和延长。② 5例（16.7%）MS患者和2例（6.7%）对照组IJVs狭窄，两组IJVs狭窄发生率差异无统计学意义（P＞0.05）。③ IJVs狭窄与DMVs减少无显著相关性（P＞0.05）。④ DMVs减少、变短与患者病程呈显著负相关（r =－0.89, P＜0.01）、与EDSS评分无显著相关性（r = 0.05, P＞0.05）；IJVs狭窄与EDSS评分和病程均无显著相关性（Z = 0.20, P＞0.05; Z = 3.46, P＜0.05）。结论 MS患者DMVs改变与IJVs狭窄无显著相关性。 [关键词] 多发性硬化; 磁共振成像; 脑深部静脉; 颈内静脉 [中图法分类号] R774.51; R814.16 [文献标志码] A Correlation of changes in cerebral deep vein and internal jugular vein with multiple sclerosis Zeng Chun, Li Yongmei, Ouyang Yu, Luo Tianyou, Lv Fajin, Chen Xuan, Wang Zhongping, Hou Huanxin (Department of Radiology, First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China) [Abstract] Objective To study the correlation of cerebral deep medullary vein (DMV) characteristic manifestations and changes in internal jugular vein (IJV) with multiple sclerosis (MS). Methods Thirty recurrent remittent MS patients (MS group) and 30 age- and sex-matched controls (control group) underwent conventional magnetic resonance imaging (MRI), 3-dimensional (3-D) enhanced T2*-weighted angiography (ESWAN), and 3-D time-resolved imaging of contrast kinetics (TRICK). Changes in periventricular DMV of MS group and control group were observed on 3-D ESWAN and scored. Results The periventricular DMV score was significantly lower in MS group than in