颅内海绵状血管瘤的影像学诊断

目的 人海绵状血管瘤的ＭＲＩ、ＣＴ和ＤＳＡ的表现。方法 经手术病理证实的颅内海绵状血管瘤７６例,其中脑内型海绵状血管瘤５９例,中颅窝鞍旁膜型海绵状血管瘤１７例。２８例行ＣＴ扫描,７３例进行ＭＲＩ检查,２０例行ＤＳＡ检查,脑内型海绵状血管瘤ＭＲＩ表现为低信号环围绕的桑葚状混杂信号团块,ＤＳＡ检查未见异常染色。中颅窝、鞍旁的病灶ＣＴ表现为较均匀的稍高密度影、ＭＲＩ呈类似哑铃形较均匀的稍长Ｔ１信号影,Ｔ     

颅内海绵状血管瘤的CT与MRI对照研究

颅内海绵状血管瘤是发生于颅内脑血管畸形的一种,其发生率占颅内脑血管畸形的7%,分脑内与脑外型,脑内型多见,常见于大脑半球皮层下区,脑外型以颅底部多见,若无出血,临床上可无任何症状与体征,因而确诊较难。搜集18例经手术与病理证实的海绵状血管瘤作回顾性分析,旨在探讨ＣＴ与ＭＲＩ对该病的诊断价值。ＣＴ与ＭＲＩ为诊断海绵状血管瘤提供了更为敏感和直观的检查方法。1　材料与方法18例中,男、女各9例,年龄17～59岁,平均38岁。主要临床症状有头痛7例,癫痫发作10例,复视、视物重影1例。ＣＴ检查10例,其中平扫4例,平扫加增强6例;ＭＲＩ检查8…     

眼眶海绵状血管瘤的MRI,CT及超声诊断评价

目的：比较ＭＲＩ、ＣＴ和超声在诊断眼眶海绵状血管瘤中的作用。材料和方法：对２１例眼眶海绵状血管瘤进行ＭＲＩ、ＣＴ及超声检查。结果：超声能够揭示海绵状血管瘤的病理组织学类型；ＭＲＩ及ＣＴ可反映肿瘤的良性特征，根据肿瘤的影像学表现及临床特点可对大多数眼眶海绵状血管瘤作出定性诊断。两种方法均有助于肿瘤的准确定位，ＭＲＩ可明确肿瘤与视神经的关系。结论：ＭＲＩ及ＣＴ对本病的诊断均有重要作用，但ＭＲＩ除能直接形成三种位置图像外，其他方面并不优于ＣＴ；超声对眼眶海绵状血管瘤的定性诊断有重要作用     

脑血管畸形的MRI诊断：与CT,脑血管造影对比分析

报道了６４例脑动静脉畸型和８例脑海绵状血管瘤的ＭＲＩ表现，并对ＭＲＩ、ＣＴ及脑血管造影在脑血管畸形诊断中的应用价值进行了对比分析。６４例脑动静脉畸形的ＭＲＩ均见到典型征象──流空信号簇。２９例见到粗大的供应动脉或／和引流静脉，１４例见到扩大的静脉窦。结果表明，ＭＲＩ对于脑动静脉畸形及其并发症的诊断优于ＣＴ，并可弥补脑血管造影的不足。ＭＲＩ与ＣＴ的联合应用对脑海绵状血管瘤的定性诊断很有意义。     

颅内海绵状血管瘤的CT、MRI与DSA对比研究

目的：探讨CT、MRI、DSA对颅内海绵状血管瘤的诊断价值。方法：经手术病理证实的颅内海绵状血管瘤27例(脑内型22例，脑外型5例)，其中9例行CT扫描，24例行MRI检查，10例行DSA检查．分别分析其影像学表现。结果：颅内海绵状血管瘤的CT表现为稍高密度影，MRI表现为混杂信号团块，DSA检查未见异常染色。结论：颅内海绵状血管瘤的MRI表现比较有特异性，综合CT、MRI和DSA所见有利于正确的诊断。     

脑原发性恶性淋巴瘤的CT和MRI诊断

目的　为提高对脑原发性恶性淋巴瘤的认识和ＣＴ、ＭＲＩ诊断水平。材料和方法　收集经病理证实的脑原发性恶性淋巴瘤１０例,其中ＣＴ检查７例,ＭＲＩ检查６例。结果　１０例病人中检出１３个病灶,ＣＴ和ＭＲＩ所见肿瘤形态不规则,其中１０个病灶有明显水肿。ＭＲＩ对原发性恶性淋巴瘤的检出率比ＣＴ更有效、ＭＲＩ示大部分病灶Ｔ_１ＷＩ呈低信号、Ｔ_２ＷＩ呈高信号。结论　分析了ＣＴ和ＭＲＩ误诊的原因后,认为ＭＲＩ应作为脑原发性恶性淋巴瘤的首选检查方法。     

脑静脉血管瘤的MRI及MRA

目的：探讨颅内静脉血管瘤的ＭＲＩ和ＭＲＡ影像学表现及诊断和鉴别诊断。材料和方法：应用ＳｉｅｍｅｎｓＭｅｇｎｅｔｉｏｎＶｉｓｉｏｎ１．５Ｔ超导系统对诊断静脉血管瘤（ＶＡ）２０例进行分析。ＭＲＩ扫描用ＳＥＴ１和ＴｕｒｂｏＳＥＴ２加权序列。ＭＲＡ采用ｔｏｆ－ｔｉ３Ｄ－ｍｕｌｔｉ－ｓｌａｂ－ｔｒａ－ｔｕｎ序列。１６例作增强Ｔ１加权及ＭＲＡ检查。血管重建采用ＭＩＰ技术。有１１例曾行ＣＴ检查，１例行手术治疗。结果：所有病例均由ＭＲ检查作出首诊。Ｔ１加权１８例显示扩张引流静脉呈点条状低信号影，有２例未显示，经增强后显示，并有部分髓静脉显示。Ｔ２加权引流静脉多呈高信号，个别呈低信号。较大的ＶＡ亦可显示髓质静脉。ＭＲＡ１５例显示异常血管，典型的表现为脑实质内见为数不等的髓质静脉呈伞状汇入一根异常扩张的引流静脉，整个形态似“水母头”。１例ＭＲＡ未显示病灶。结论：ＭＲ是诊断ＶＡ最好的影像方法，ＭＲＡ有助于确诊本病。增强ＭＲＩ及ＭＲＡ可提高ＶＡ的检出率     

CT、MRI与DSA在脑内型海绵状血管瘤诊断中的价值

目的探讨CT、MRI与DSA检查在脑内型海绵状血管瘤诊断中的价值。资料与方法回顾性分析经手术病理证实的22例脑内型海绵状血管瘤患者资料,CT平扫22例,其中增强扫描17例。MRI检查22例,其中增强扫描13例。DSA检查5例。结果CT表现为高密度,略高密度,等密度。MRI表现为T1WI呈等或略低信号、T2WI呈高信号;T1WI与T2WI均呈高信号,病灶周围可见低信号环;T1WI与T2WI均呈低信号。病灶无占位效应或占位效应轻微,病灶多为不强化及轻微强化。DSA检查无肿瘤染色。结论脑内型海绵状血管瘤MRI表现典型,比CT表现更具特异性,与CT检查结合是诊断脑内型海绵状血管瘤的有效方法,参考DSA表现有利于脑内型海绵状血管瘤的诊断。     

脑原发性恶性淋巴瘤和CT和MRI诊断

目的 为提高对脑原发性恶性淋巴瘤的认识和ＣＴ、ＭＲＩ诊断水平、材料和方法 收集经病理证实的脑原发性恶性淋巴瘤１０例,其中ＣＴ检查７例、ＭＲＩ检查６例,结果 １０例病人中检出１３个病灶,ＣＴ和ＭＲＩ所见肿瘤形态不规则,其中１０个病灶有明显水肿。ＭＲＩ对原发性恶性淋巴瘤的检出率比ＣＴ更有效,ＭＲＩ示大部分病灶Ｔ１ＷＩ呈低信号,Ｔ２ＷＩ呈高信号。结论 分析了ＣＴ和ＭＲＩ的原因后,认为ＭＲＩ应作为脑原发性     

颅内黑色素瘤的影像诊断(附7例分析)

目的：探讨颅内黑色素瘤ＣＴ、ＭＲ影像特征及其诊断。材料和方法：７例颅内黑色素瘤患者中男４例,女３例,年龄１０～５９岁。５例皮肤有黑色素瘤,２例有颅内黑色素瘤切除史。２例行ＣＴ加ＭＲＩ,４例单行ＭＲ,１例仅行ＣＴ检查。结果：３例ＣＴ平扫均为高密度影,形态不规则。增强扫描肿瘤明显增强。６例ＭＲＩＴ１ＷＩ肿瘤均表现为高信号,其中５例Ｔ２ＷＩ低信号,１例低高信号。Ｔ１ＷＩ增强扫描６例不规则增强。结论：颅内黑色素性黑色素瘤ＭＲＩ具有特征性表现,而非黑色素性黑色素瘤不具特征性,ＭＲＩ显示黑色素瘤累及脑实质及浸润脑膜的范围和定性诊断优于ＣＴ。     

脑实质海绵状血管瘤的CT和MRI诊断

目的:探讨脑实质海绵状血管瘤(cavernous angioma,CA)的CT、MRI表现及其诊断价值.材料和方法:回顾性分析15例经手术病理证实为CA的CT和MRI表现. 结果: 15例CA共检出19个病灶.CA可发生于脑内任何部位,单发多见(13/15).15例CT和MRI平扫均发现所有病灶.CA的CT平扫均表现为高或稍高密度;CA的MRI平扫表现为T1WI呈等或低信9个,高信号7个,混杂信号3个;T2WI呈高低混杂信号,16个病灶周围伴有低信号环,无占位效应;CT和MRI增强扫描无或轻度增强.结论: CA有典型影像表现,CT和MRI平扫对明确诊断具有重要意义,MRI优于CT,是首选和最佳的影像学方法.     

螺旋CT及MRI在鉴别肾脏囊性占位病变中的作用

目的分析肾脏囊性占位病变的CT与MRI表现,并评价其对鉴别良恶性病变的临床意义。方法 151例由手术病理证实的肾脏囊性占位病变患者,包括多发囊肿125例,海绵状血管瘤16例及囊性肾癌10例,均经CT与MRI平扫及增强扫描。比较了CT与MRI对肾脏囊性占位病变的诊断能力。结果 151例中,CT诊断肾囊肿118例,血管瘤16例,以及囊性肾癌17例,其诊断敏感性,特异性及准确性分别为58.8%,95.0%及95.4%;MRI诊断肾囊肿122例,血管瘤16例,以及囊性肾癌13例,其诊断敏感性,特异性及准确性分别为76.9%,98.8%及98.0%。CT对肾良性病变低估7例,对恶性病变高估了7例,而MRI对肾良性病变低估3例,对恶性病变高估3例。结论 CT与MRI二者都能对血管瘤作出正确诊断,而在肾囊肿与囊性肾癌的诊断及鉴别诊断中,MRI明显优于CT。     

Simultaneous occurrence of developmental venous anomalies and cavernous angiomas.

PURPOSETo study the clinical and radiologic findings in 15 patients presenting with both developmental venous anomalies and cavernous angiomas and to determine which lesions caused the acute clinical symptoms.METHODSLesions were infratentorial in 7 patients and supratentorial in 7 other patients. In one patient the developmental venous anomaly was infratentorial and the cavernous angioma supratentorial. In all 15 patients clinical examination and CT were performed. In 10 patients MR was performed at the time of the initial CT scan. In 5 patients only late MR is available.RESULTSAcute clinical signs were present in 9 patients (epilepsy, hemiplegia, meningeal signs, cranial nerve deficit). On CT the cavernous angioma was missed in 9 patients, in 6 patients because of acute hemorrhage. On MR the cavernous angioma was missed in 1 of 2 cases with acute hemorrhage but seen in all other patients. On repeat MR all cavernous angiomas were correctly identified. On CT, 11 developmental venous anomalies were seen. On MR all developmental venous anomalies were seen.CONCLUSIONSThe frequent association of developmental venous anomalies and cavernous angiomas is confirmed. MR is superior to CT in the detection of both cavernous angiomas and developmental venous anomalies. Furthermore our data support the hypothesis that cavernous angiomas and not the developmental venous anomalies cause the acute clinical symptoms because of hemorrhage.     

脑内出血性海绵状血管瘤的MRI诊断

目的:分析脑内出血性海绵状血管瘤(IHCA)的MRI表现特点。方法:回顾性分析25例经病理证实的脑IHCA的MRI资料。结果:25例病变均为单发,幕上18例,幕下7例,其中大脑半球11例,基底节及丘脑7例,脑干5例,小脑2例,病变形态以类圆形为主,由于反复多次出血信号不均匀,增强无或轻度强化。结论:脑IHCA的MRI表现有一定特征性,但与其它颅内病变有类似之处,认真分析其特点,可提高诊断准确性。     

颅内海绵状血管瘤的CT和MRI诊断

目的:探讨脑内与脑外海绵状血管瘤的CT和MRI表现及诊断价值.方法:搜集45例颅内海绵状血管瘤的CT和MRI影像资料进行分析,MRI检查45例,CT检查30例,其中脑内型海绵状血管瘤42例,脑外型海绵状血管瘤3例,均经手术病理证实.结果:脑内型海绵状血管瘤可位于脑内任何部位,单发病灶多见,无明显占位效应,周围无或轻度水肿.CT检查的全部病例呈稍高及混杂密度影27例,增强扫描大都无强化;MRI检查T2 WI表现为"桑葚状"混杂高信号,周围有云絮状低信号环,增强后病灶仅少数轻度强化.脑外型病灶位于中颅窝鞍旁,MRI呈类似哑铃形或类圆形较均匀的稍长T1明显长T2信号,增强扫描呈明显均匀强化.结论:脑内与脑外型海绵状血管瘤的CT和MRI表现具有一定特征,MRI优于CT像,特别是MRI的T2 WI像有助于明确诊断.     

Dural cavernous angioma: MR features.

The imaging features of a cavernous angioma, which originated from the meninges, are presented. The patient harbored a second cavernous angioma within the brain parenchyma. Cavernous angioma should be included in the differential diagnosis of dural lesions, especially when other cavernous angiomas are present.     

Multiple spinal intramedullary cavernous angiomas with bleeding episode mimicking an intramedullary tumor

Intramedullary cavernous angioma is a rare vascular malformation compared to cerebral cavernous malformation. The incidence of cavernous angioma is about 3 – 5% of all central nervous system lesions, 5 – 12% of all spinal vascular lesions, and 1% of all intramedullary lesions in pediatric patients. Although intramedullary cavernous angioma has the same histological picture as cerebral cavernous angioma, the natural history, and surgical approach are different from cerebral cavernous angioma. Due to its location in the eloquent area of the spinal medulla, a slight change in the size of the lesion can affect the neurological function of the patient. We describe a case of an intramedullary cavernous angioma with hemosiderin post bleeding, located in the cervical cord which was initially misdiagnosed as hemorrhagic ependymoma. On whole spine MR imaging we also found an intramedullary cavernous angioma in the lower thoracal cord at the T12 level with mild hemorrhage. Abdominal MRI showed cavernous angiomas in both kidneys. The patient underwent surgical treatment with removal of the lesion in the cervical cord and T12 level, with histopathologic findings consistent with cavernous angioma. No malignancy was detected. Post-surgery, the symptoms gradually improved. Symptomatic intramedullary cavernous angioma tends to bleed repeatedly and being unstable. Early diagnosis and surgical treatment can prevent rebleeding and more severe symptoms.     

Cerebral vascular malformations: applications of magentic resonance imaging to differential diagnosis

Summary Twelve patients with cerebral vascular malformations (5 cavernous angiomas, 1 thrombosed arteriovenous malformation, and 6 venous angiomas) were studied with magnetic resonance (MR) imaging. All lesions were clearly depicted. Characteristic MR findings were obtained mainly on T2-weighted images: a markedly low intensity area was always seen. The margins of arteriovenous malformation (AVM) and venous angioma were irregular while those of cavernous angioma were smooth in all planes on T2-weighted images. Gradient-echo (GrE) pulse sequences were more sensitive than T2-weighted spin echo (SE) in lesion detection. MR imaging could play an important role in the differential diagnosis of cerebral vascular malformations.     

Familial form of intracranial cavernous angioma: MR imaging findings in 51 families. French Society of Neurosurgery

PURPOSE: To analyze the magnetic resonance (MR) imaging features of familial cerebral cavernous angioma in non-Hispanic families. MATERIALS AND METHODS: Between November 1996 and June 1997, 51 non-Hispanic families with familial cavernous angioma were identified. Cerebral MR images in 83 symptomatic subjects and 73 asymptomatic subjects were reviewed. Spin-echo (SE) and gradient-echo (GRE) MR imaging features of cavernous angioma were recorded and, in 91 subjects with both SE and GRE images, lesions were graded as type 1, 2, 3, or 4, according to a published classification scheme. MR imaging features were compared between symptomatic and asymptomatic subjects, and sensitivities of SE and GRE images were determined. RESULTS: Multiple lesions were more common than single lesions in both symptomatic and asymptomatic subjects, with no difference in mean number of lesions between groups. More lesions were detected on GRE images than on SE images. Type 1 and type 2 lesions were more numerous in symptomatic than in asymptomatic subjects. The numbers of types 2, 3, and 4 lesions increased with age in both groups. CONCLUSION: The familial form of cavernous angioma is characterized by multiple lesions and by a correlation between lesion number and subject age. The clinical manifestation may be more closely related to the type of lesion than to the number of lesions. GRE MR images are more sensitive than SE images for demonstration of cavernous angioma.