重度颅内动脉狭窄活体高分辨磁共振成像初探

目的 观察症状性重度颅内动脉狭窄(SSIS)活体高分辨磁共振成像(HRMRI)的初探结果.方法 用3.0T MR扫描仪对5例SSIS患者进行HRMRI检查,盲法分析影像资料.结果 3例管壁呈典型的粥样硬化改变,呈偏心性增厚、大的脂质坏死核心、纤维帽破裂、不均匀强化.2例管壁为非粥样硬化可能性大,1例管腔内可见斜形隔膜与轻度增厚的管壁相连,增强后呈均匀强化;另1例管壁向心性明显增厚,增强后无强化.结论 SSIS的活体HRMRI成像是可行的,能够提供狭窄处的管壁信息,但仍需进一步研究其应用价值.

In vivo high-resolution magnetic resonance imaging in severe intracranial stenosis

Objective To assess the feasibility and clinical value of high-resolution magnetic resonance imaging (HRMRI) in patients with symptomatic severe intracranial stenosis (SSIS).Methods HRMRl wasperformed with a 3.0 T MR scanner on 5 patients with symptomatic middle cerebral(n=3) or basilar (n=2) arterial stenosis of≥70% confirmed bv DSA.Image diagnosis Was made on the basis of HRMRI findings of vessel wall at the stenotic segment by 2 neuroradiologists blinded t0 patient's status.Results Three of the five patients were diagnosed to have advanced intracranial atherosclerosis based on the presence of a complex eccentric atherosclerotic plaque containing a large lipid-rich necrotic core with a heterogeneous post-contrast enhancement and with signs of ruptured fibrous cap.Two other patients were likely to suffer from non-atherosclerotic lesion.HRMRI revealed an iso-signal septum in the arterial lumen attaching to the slighfly thickened arterial wall that was iso-signal with a homogeneous post-contrast enhancement in one patient and an obviously concentrically thickened arterial wall with hypo-intense signal on T1 WI and slightly high signal on T2 WI and PDWI and without any post-contrast enhancement in the remaining patient.Conclusions In vivo HRMRI in patients with SSIS is technically feasible.It provides detailed information of intracranial arterial wall at the stenotic segment.