外伤性蛛网膜下腔出血致中枢神经系统表面铁质沉积症的 MRI 评价

目的：探讨 MRI 三维增强 T2?加权血管成像(ESWAN)序列在评价外伤性蛛网膜下腔出血(tSAH)引起中枢神经系统表面铁质沉积症(SS-CNS)的价值。方法30例 tSAH 患者行头颅 MRI 的 ESWAN 序列和 GRE T2? WI 序列扫描,比较2种序列图像上 SS-CNS 检出率和分布区域计数的差异,统计学方法分别采用 McNemar 检验和 Wilcoxon 符号秩和检验。结果30例tSAH 患者中 SS-CNS 阳性率为96.7%(29/30),SS-CNS 分布区域总计是134个；24例同时行2种序列扫描的 tSAH 患者,ESWAN 序列和T2? WI 序列图像上 SS-CNS 检出率分别是95.8%(23/24)和66.7%(16/24),McNemar 检验显示有明显统计学差异(χ2=7.0,P <0.05)；2种序列图像上显示的 SS-CNS 分区计数分别是106个和34个,Wilcoxon 符号秩和检验结果显示有明显统计学差异(Z =-4.225,P <0.01)。结论绝大部分 tSAH 患者会引起不同程度的 SS-CNS；ESWAN 序列是一种能有效、可靠地评估 tSAH 后 SS-CNS 影像学方法。

MRI evaluation of superficial siderosis of the central nervous system after traumatic subarachnoid hemorrhage

Objective To assess the diagnostic value of 3D-enhanced T2 ? weighted angiography (ESWAN )in evaluating superficial siderosis of the central nervous system (SS-CNS)after traumatic subarachnoid hemorrhage (tSAH).Methods ESWAN and GRE T2 ? WI sequence were performed on 30 patients with tSAH,detection rate and the number of distribution areas of SS-CNS were compared between the two sequences.A McNemar’s test and Wilcoxon signed-rank test were used to analyze the differences between T2 ? WI and ESWAN images sequences. Results In the tSAH group,29 of 30 patients (96.7%)showed SS-CNS on ESWAN images,the total number of SS-CNS regions was 134.Identified SS-CNS positive rate respectively was 95.8% (23/24)on ESWAN images and 66.7% (1 6/24)on T2 ? WI in 24 patients simultaneously perform ESWAN and T2 ? WI sequences.A McNemar ’s test showed that there was significant difference between the positive rates of two sequences in detecting the SS-CNS (χ2 =7.0,P <0.05).The number of SS-CNS regions on ESWAN images and T2 ? WI was 106 and 34 respectively.The Wilcoxon signed rank test showed that the number of SS-CNS regions difference between two sequences was significant (Z =-4.225,P <0.01).Conclusion Various degress of SS-CNS are detected in a majority of tSAH atients.ESWAN sequence is a reliable and efficient method for assessment of SS-CNS.