脑发育性静脉异常并出血的影像学诊断

目的:探讨脑发育性静脉异常(DVAs)并出血的影像学表现。方法:回顾性分析7例随访证实为DVAs并出血病例的CT及MRI表现。结果:发生在左、右额叶白质内各1例,右侧基底节2例,右侧小脑中脚1例,左、右侧小脑半球各1例。CT平扫2例呈结节状高密度灶,1例呈卵圆形低密度灶。MRI平扫时DVAs呈长T1,长、短T2信号,3例呈"水母头征",出血灶呈片絮状短、长T1,长、短T2信号,条状短、长T1,短T2信号。MRI增强扫描1例未见强化,其他均明显强化,呈"水母头征",显示清晰。磁敏感加权成像(SWI)示5例呈低信号,呈典型"水母头征",显示清晰,出血灶呈结节状低信号,边界清晰。结论:MRI对DVAs并出血的诊断有明显优势,以SWI更为显著。

Diagnosis of the imaging of developmental venous anomalies with haemorrhage

Objective： To investigate the imaging manifestations of developmental venous anomalies with haemorrhage. Methods： The CT and MRI results of 7 patients were analyzed. Results： Lesions were located in frontal lobe （ n = 2）, right basal ganglia （ n =2） ,middle cerebellar peduncle（ n = 1） ,cerebellum（ n =2）. CT plain scan showed nodular lesions with high-density in 2 cases and oval lesion with low-density lesion in 1 case. DVAs showed low signal on T1WI and high-low mixed signals on T2WI. Hemorrhagic lesions showed high-low signals on T1WI and T2WI. The typical caput medusae sign were presented in 3 cases. CE-MRI was able to exhibit the detail of DVAs and the caput medusae sign in 6 cases. 5 cases examined on SWI could be shown the caput medusae sign in all. Hemorrhagic lesions showed nodular hypointensity with clear border. Conclusion： MRI has advantages in the diagnosis of DVAs with haemorrhage,and SWI can be used as an important supplement to routine MRI sequence.