脑血管(V-R)间隙的MRI诊断与鉴别诊断.pptVIP

2021/3/26 * Thanks for your attention Figure 2. Drawing shows a cortical artery with a surrounding VR space crossing from the subarachnoid and subpial spaces through the brain parenchyma. The magnified view on the right shows the anatomic relationship between the artery, VR space, subpial space, and brain parenchyma Figure 7. Type III VR space in a 25- year-old man. (a) Axial proton-density– weighted image (2620/100) shows a hyperintense spot in the brainstem (arrow). (b) Axial FLAIR image (7292/ 120) obtained at the same level shows that the spot has CSF-like content without abnormal surrounding signal intensity (arrow). These findings confirm that the spot is a VR space. Figure 8. Type III VR spaces in a 68-year-old man. (a) Axial proton-density–weighted image (2382/100) shows multiple punctate hyperintense areas in the brainstem (arrow). (b) Close-up T2-weighted image (4615/120) clearly shows the fine punctate pattern. (c) Axial FLAIR image (6609/100) shows the CSF-like content of the dots (arrow). No surrounding high signal intensity is seen. The typical configuration and the fact that no high signal intensity is seen on the FLAIR image confirm that the dots are VR spaces. T1, PD, T2 2021/3/26 * 腔隙性脑梗死 T2 FLAIR ADC 急性与慢性腔梗 2021/3/26 * 中枢神经系统原发性血管炎（primary angiitis of the central nervous system,PACNS） 又称为中枢神经系统肉芽肿性血管炎,或孤立性中枢神经系统血管炎 PACNS多见于30-40岁男性,临床表现多种多样,局灶性体征或全脑、脑膜受累表现。 活检病理显示受累血管为毛细血管前后的小动脉和小静脉,提示小血管疾病。 2021/3/26 * 中枢神经系统原发性血管炎（primary angiitis of the central nervous system,PACNS） 头颅MRI可发现点状或片状异常信号,散在或弥散,皮质下和深部白质最常见。 病灶有波动性,即病灶大小和数目易变,有时可消失。 增强检查血管周围间隙可有强化,具有特异性。可能与软脑膜的浸润有关,但并非常见。 2021/3/26 * 18岁男性,复视,进行性共济失调,言语不清。脑干、桥臂、小脑多发点状高信号,增强后明显强化;1月后治疗后复查:病灶明显减少。 T2 T1 C+ 1月后 T2 2021/3/26 * 38岁男性,下肢轻瘫2月,突发急性头痛,幻觉; 双侧大脑半球灰白质多发散在、片状长T2信号, 1月后复查部分病灶消失。 T2 1月后 T2 2021/3/26 * 4月后 : FLAIR T2 T1 C+ 病灶较之前