3.0T磁共振磁敏感加权成像诊断脑发育性静脉畸形

目的 评价磁敏感加权成像(SWI)在诊断脑发育性静脉畸形(DVA)中的临床应用价值.方法 选取采用3.0T超高场磁共振的SWI及常规MR序列(包括自旋回波T_1加权像、快速自旋回波T_2加权像)诊断为脑发育性静脉畸形的24例患者,对SWI及常规MR序列进行分析.结果 24例脑发育性静脉畸形中发生于额叶白质11例,顶叶白质6例,颞叶2例,小脑半球5例.MR平扫显示DVA病灶11例,其中表现为条状流空信号者4例,表现为T_2WI放射状高信号者7例;MR增强检查显示所有病灶,表现为"海蛇头"样强化特征.SWI检查清晰显示所有病灶,表现为"海蛇头"样低信号影.结论 SWI对小静脉病变较敏感,能取代MR增强检查用于脑发育性静脉畸形的诊断和随访.     

脑静脉性血管瘤的MRI及磁敏感加权成像表现

目的 评价磁敏感加权成像(susceptibility weighted imaging,SWI)在脑静脉血管畸形的诊断价值.方法 回顾性分析16例脑静脉性血管瘤(CVH)的MRI表现.16例均行MRI平扫,其中10例行MR增强扫描,10例行SWI检查.结果 16例中,发生于小脑半球6例,顶叶4例、额叶2例、颞枕叶2例、枕叶1例,侧脑室旁1例,伴发海绵状血管瘤1例.16例中,MRI平扫显示病灶13例,表现为管状、小圆状低信号;10例MR增强检查显示所有病灶,表现为"水母头"样强化;10例SWI均能清晰显示病灶,表现为"水母头"样低信号影;结论 MRI结合SWI是诊断CVH的无创和有效手段.     

磁敏感加权成像在脑静脉血管瘤诊断中的应用

目的 分析脑静脉血管瘤的磁敏感加权成像(SWI)表现,探讨SWI在脑静脉血管瘤诊断中的应用价值.方法 对10例经影像诊断为脑静脉血管瘤患者的SWI及MRI图像进行分析.结果 10例病例单发者8例,多发者2例,均合并眼眶占位.8例单发者病变位于幕上者7例,幕下者1例;2例多发者幕上、幕下均见病灶分布.10例中有5例MR平扫时可以发现粗大引流静脉,但髓静脉显示不清;另外5例MR平扫显示不清或者仅为不均匀信号不易发现.4例行增强扫描者异常静脉均明显强化呈典型的"水母头"样改变.所有SWI检查均清楚地显示细小髓静脉及粗大引流静脉,表现为典型的"水母头"状或树枝样低信号,而且对于合并的出血以及海绵状血管瘤等亦能很好地显示.结论 SWI能清楚显示髓静脉及引流静脉,可以用于脑静脉血管瘤的诊断及随访.     

T2*加权血管成像与磁共振增强在脑血管畸形诊断的应用价值

目的:探讨T2*加权血管成像(T2*Weighted Angiography,SWAN)与磁共振增强对脑血管畸形的诊断价值.方法:回顾性研究45例临床确诊脑血管畸形患者的MR常规、增强与SWAN表现.比较病变的显示情况.结果:SWAN和增强MR均能显示静脉畸形特征性"海蛇头"样改变;海绵状血管瘤SWAN呈结节状低信号,增强后无或轻度强化.毛细血管扩张症SWAN呈斑点状低信号,增强MR表现为模糊晕状或毛刷样增强,中央可见点状强化静脉,SWAN能显示其反复出血及海绵状血管瘤形成.结论:SWAN联合增强检查对脑血管畸形尤其是静脉畸形、海绵状血管瘤、混合型血管畸形的诊断,提供重要价值信息.     

颅内海绵状血管瘤的CT和MRI诊断

目的 探讨CT和MRI对颅内海绵状血管瘤的表现和诊断价值。资料与方法 经手术病理证实的颅内海绵状血管瘤22例,其中脑内型海绵状血管瘤21例,脑外型海绵状血管瘤1例。10例行CT检查,16例行MRI检查,13例行MRA检查。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,周围无或轻度水肿,无明显占位效应。CT平扫为稍高密度影,钙化占72．7％,增强扫描大都无强化;MR T1WI表现为桑葚状混杂高信号．周围有云絮状低信号环,增强后病灶大都无强化;MRA检查未见异常血管。脑外型病灶位于中颅窝、鞍旁,MRI呈类似哑铃形较均匀的稍长T1、长T2信号,增强扫描见明显均匀强化．MRA检查未见异常血管。结论 脑内型海绵状血管瘤的MRI表现较有特异性,结合CT和MRA可明确诊断;脑外型者易误诊,对CT和MRI表现类似的中颅窝脑膜瘤,应考虑到本病的可能。     

磁敏感加权成像在颅内海绵状血管瘤诊断中的应用价值

目的 探讨磁敏感加权成像(SWI)技术在颅内海绵状血管瘤诊断中的应用价值.方法 对29例CT或MR常规检查疑有海绵状血管瘤的患者进行磁敏感加权成像序列扫描.结果 29例病例中单发者为21例,多发者为8例.其中13例为手术病理证实,其余经多位临床及影像副主任医师分别诊断为海绵状血管瘤.常规扫描发现病灶82个,其中表现为典型血管瘤征象("铁环征")为30个.磁敏感序列发现144个,其中均匀性低信号病灶117个,低信号中含有混杂信号病灶27个.结论 磁敏感加权成像对于颅内海绵状血管瘤特别是在常规MR扫描无阳性表现或不典型者具有很高的应用价值.     

脑静脉血管瘤的MRI诊断

目的 探讨MRI对脑静脉血管瘤的诊断价值.方法 回顾性分析17例脑静脉血管瘤的MRI表现.结果 17例常规MR均可显示引流静脉,其中8例可显示髓静脉汇入引流静脉;6例增强扫描及7例磁敏感加权成像(SWI)均可清晰显示引流静脉及髓静脉,呈现特征性的"海蛇头"征.结论 脑静脉血管瘤的MRI表现极具特征性,增强扫描或SWI较常规MRI能更加清晰地显示脑静脉血管瘤的影像特征,是诊断本病的可靠方法.     

海洛因海绵状白质脑病的CT和MR表现

目的：总结海洛因海绵状白质脑病的CT及MRI特征。方法：分析5例海洛因海绵状白质脑病的临床特点，影像表现及1例病理所见，总结其CT和MRI的诊断要点。结果：海劣因海绵状白质脑病的CT和MRI特征为：（1）病变广泛累及小脑，大脑白质及脑博干，内囊后肢，多以小脑损害为重，其中以小脑中线两侧对称性边界清楚的类圆形蝴蝶样病灶为特征。（2）病灶双侧对称，边界清楚；（3）CT示病灶为低密度。MRI示病灶为T1WI低信号以及T2WI高信号影；（4）增强病灶无强化。主要的病理改变为脑白质的空泡样变性。结论：海洛因海绵状白质脑病的CT和MR表现为特征性改变，有海洛因烫吸史者，一旦出现小脑受损的表现，应及早行头部影像学检查明确诊断。     

鞍旁海绵状血管瘤的CT和MRI诊断

目的总结7例鞍旁海绵状血管瘤CT、MRI和磁共振波谱（MRS）表现,探讨其诊断和鉴别诊断。资料与方法7例均经手术病理证实,均行CT和MR平扫,2例行CT增强扫描,7例行MR增强扫描,5例行MR扩散加权成像（DWI）,6例行^1H MRS检查。结果鞍旁海绵状血管瘤体积大,并同时伸入到鞍内。CT平扫病变呈等或稍高密度,密度均匀,MR T1WI呈等或稍低于脑灰质信号,T2WI呈类似脑脊液高信号。增强扫描病变呈非常显著强化。DWI呈等或稍低信号,但表观扩散系数（ADC）值明显高于正常脑实质。。HMRS表现为NAA峰、Cr峰和Cho峰消失。可出现Lip峰。结论CT检查时鞍旁海绵状血管瘤与脑膜瘤和垂体瘤鉴别困难,MRI表现很有特点,T2WI呈极高信号,增强扫描非常显著强化,ADC值明显升高而DWI接近等信号,MRS检查无NAA峰、Cr峰和Cho峰,MRI可以对海绵窦海绵状血管瘤作出定性诊断。     

磁共振SWI与GRE-T_2~* WI序列用于诊断脑海绵状血管瘤的价值

目的探讨磁敏感加权成像(SWI)与T2加权梯度回波成像(GRE-T_2*WI)用于诊断脑海绵状血管瘤的价值。方法分析33例脑海绵状血管瘤的MR资料,评估SWI及GRE T_2*WI序列显示病灶的位置、数目及大小,并对所显示病变的大小及数目进行统计分析。结果 SWI显示海绵状血管瘤的数目明显高于GRE T_2*WI(77:44,P0.001);SWI显示海绵状血管瘤的尺寸明显大于GRE T_2*WI(0.5cm±0.14;0.3cm±0.13,P0.001)。结论 SWI序列诊断脑海绵状血管瘤较GRE T_2*WI敏感,对脑海绵状血管瘤或疑似患者进行常规MR检查时有必要添加SWI序列。     

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。     

MR evaluation of developmental venous anomalies: medullary venous anatomy of venous angiomas.

PURPOSETo present characteristic MR findings of developmental venous anomalies (DVAs) in terms of location of caput and draining veins, to correlate these findings with normal medullary venous anatomy, and to suggest an approach to the evaluation of DVAs by means of MR imaging.METHODSWe reviewed the contrast-enhanced MR examinations of 61 patients with DVA, which were selected from 4624 consecutive cranial MR examinations. Site of the DVA and size and direction of draining veins were recorded.RESULTSSeventy-two DVAs with 78 draining veins were located: 18 were juxtacortical, 13 were subcortical, and 41 were periventricular or deep. Twenty-six of the DVA caputs were frontal, 16 were parietal, 13 were in the brachium pontis/dentate, seven were in the temporal lobe, three were in the cerebellar hemisphere, three were in the occipital lobe, three were in the basal ganglia, and one was in the pons. The draining veins were superficial in 29 cases and deep in 49. Of the 36 supratentorial deep draining veins, 16 were in the trigone/occipital horn, 11 were in the mid-body of the lateral ventricle, seven were in the frontal horn, and two were in the temporal horn. Among the 14 infratentorial deep draining veins, five were in the lateral recess of the fourth ventricle, four were anterior transpontine veins, three were lateral transpontine veins, and two were precentral cerebellar veins.CONCLUSIONThe DVA caputs and their draining veins occurred in typical locations that could be predicted from the normal medullary venous anatomy, with the frontal, parietal, and brachium pontis/dentate being the most common locations. Drainage can occur in superficial cortical veins or sinuses or in deep ventricular veins or in both, no matter where the caput is located. Whether drainage was superficial or deep could not be predicted on the basis of the site of the DVA caput. Contrast-enhanced T1-weighted MR images showed the DVAs best, but diagnosis could be made from T2-weighted MR images.     

磁敏感加权成像对颅内多发海绵状血管瘤的诊断价值

目的:探讨磁共振磁敏感加权成像序列(SWI)对脑内多发海绵状血管瘤的诊断价值。方法:前瞻性地采用磁共振SWI序列及快速自旋回波序列TSE-T1WI、T2WI对6例颅内多发海绵状血管瘤患者进行扫描,分析MRI不同扫描序列图像区别。结果:6例患者中TSE T1WI发现海绵状血管瘤病灶23个,TSE T2WI发现病灶92个,SWI发现病灶192个。结论:在显示颅内多发海绵状血管瘤方面,SWI较TSE序列有明显优势,特别是对于小病灶的检出。     

脑转移瘤MRI增强扫描的诊断与鉴别诊断

目的 :评价磁共振增强扫描对脑转移瘤诊断与鉴别诊断的价值。方法 :回顾性地分析了 35例经临床及手术病理证实的脑转移瘤 ,总结了其平扫和增强扫描的MRI征象 ,并将增强新后发现的病灶个数进行配对t检验。结果 :单纯幕上双侧大脑半球内发现病灶的有 2 1例 ,平扫发现 4 3个病灶 ,增强扫描发现 91个病灶 ;单纯幕下双侧小脑半球内发现孤立性病灶者有 6例 ,平扫 6个病灶 ,增强扫描 8个病灶 ;幕上幕下均发现病灶者有 8例 ,平扫发现 2 7个病灶 ,增强扫描有6 0个病灶。增强扫描前后病灶均数的统计分析t值为 2 347,P <0 0 5。结论 :Gd DTPA增强扫描更好地展示了平扫时不能显示的病灶 ,对脑转移瘤的诊断和鉴别诊断有重要的临床价值和意义。     

超高场3.0T磁共振磁敏感加权成像诊断隐匿性脑血管畸形的临床应用

目的 探讨磁敏感加权成像( SWI)诊断隐匿性脑血管畸形(angiographically occult cerebrovascular malformation,AOVM)的应用价值.资料与方法 回顾性分析119例AOVM(海绵状血管瘤42例,毛细血管扩张症46例,发育性静脉畸形31例)患者的MRI表现,比较SWI与其他常规MRI序列显示AOVM的敏感性和特异性.结果 119例中,以SWI发现病灶数目最多,并且其影像表现具有特征性,与其他常规MRI序列相比,病灶检出的差异有统计学意义(P＜0.05).结论 SWI显示AOVM较其他常规MRI序列有更高的敏感性和特异性,是诊断AOVM的最佳序列,应作为AOVM的常规检查序列.     

软组织海绵状血管瘤的MRI诊断

目的探讨软组织海绵状血管瘤的MRI表现及其诊断价值。方法回顾性分析35例软组织海绵状血管瘤患者的影像资料,全部患者均有MRI平扫和增强扫描,12例有X线平片检查,10例有CT检查。结果单发病灶31例,2~4个多发病灶者4例,共检出43个病灶。SE序列T1WI上33个病灶呈中等略高信号,T2WI上全部病灶呈高信号,信号不均匀。33个病灶内及周边可见高信号的病变,Flash2d序列21个病灶T1WI上高信号被抑制,12个病灶内T1WI上高信号未被抑制。Gd-DTPA增强扫描39个病灶呈明显强化,但强化不甚均匀,其内可见点条状不强化影。结论软组织海绵状血管瘤在MRI表现上有一定特征性,MRI对诊断软组织海绵状血管瘤有重要价值。     

Parenchymal abnormalities associated with developmental venous anomalies

Introduction To report a retrospective series of 84 cerebral developmental venous anomalies (DVAs), focusing on associated parenchymal abnormalities within the drainage territory of the DVA. Methods DVAs were identified during routine diagnostic radiological work-up based on magnetic resonance imaging (MRI) (60 cases), computed tomography (CT) (62 cases) or both (36 cases). Regional parenchymal modifications within the drainage territory of the DVA, such as cortical or subcortical atrophy, white matter density or signal alterations, dystrophic calcifications, presence of haemorrhage or a cavernous-like vascular malformation (CVM), were noted. A stenosis of the collecting vein of the DVA was also sought for. Results Brain abnormalities within the drainage territory of a DVA were encountered in 65.4% of the cases. Locoregional brain atrophy occurred in 29.7% of the cases, followed by white matter lesions in 28.3% of MRI investigations and 19.3% of CT investigations, CVMs in 13.3% of MRI investigations and dystrophic calcification in 9.6% of CT investigations. An intracranial haemorrhage possibly related to a DVA occurred in 2.4% cases, and a stenosis on the collecting vein was documented in 13.1% of cases. Parenchymal abnormalities were identified for all DVA sizes. Conclusion Brain parenchymal abnormalities were associated with DVAs in close to two thirds of the cases evaluated. These abnormalities are thought to occur secondarily, likely during post-natal life, as a result of chronic venous hypertension. Outflow obstruction, progressive thickening of the walls of the DVA and their morphological organization into a venous convergence zone are thought to contribute to the development of venous hypertension in DVA. Presented at the 44th Annual Meeting of the American Society of Neuroradiology, San Diego, Calif., USA, May 1–5, 2006.     

脑血管畸形在3.0T MR磁敏感加权成像中表现多样性分析

目的:探讨脑血管畸形在3.0T MR磁敏感加权成像(SWI)上表现多样性的病理生理基础.方法:回顾性分析33例具有典型影像学表现或经手术病理证实的脑血管畸形患者.其中海绵状血管瘤24例(2例合并毛细血管扩张症),动静脉畸形(AVM)5例,发育性静脉畸形(DVA)3例,Galen静脉血管畸形合并永存镰状窦1例,毛细血管扩...     

High-signal-intensity abnormalities evaluated by 3D fluid-attenuated inversion recovery imaging within the drainage territory of developmental venous anomalies identified by susceptibility-weighted imaging at 3 T

Purpose

To evaluate brain parenchymal high-signal-intensity abnormalities within the drainage territory of developmental venous anomalies (DVAs) identified by susceptibility-weighted imaging (SWI) at 3 T.

Methods

One hundred and thirty patients with 137 DVAs identified by SWI were retrospectively studied. 3D fluid-attenuated inversion recovery (FLAIR) images were reviewed for parenchymal high-signal-intensity abnormalities and SWI images were reviewed for hypointense foci (microhemorrhages or cavernous malformations) adjacent to DVAs. Patient age, the degree of underlying white matter disease, DVA location (supratentorial or infratentorial), and the presence or absence of hypointense foci were compared across DVAs with and without high-signal-intensity abnormalities. The correlation between patient age and the size of any high-signal-intensity abnormality was analyzed using linear regression.

Results

Forty-two of 137 DVAs (30.7 %) had high-signal-intensity abnormalities. An adjusted prevalence of 18/71 (25.4 %) was obtained after excluding patients with considerable underlying white matter disease. Only DVA location (supratentorial) was associated with the presence of high-signal-intensity abnormalities (p < 0.05). There was a significant correlation between patient age and the size of high-signal-intensity abnormalities (p < 0.01).

Conclusions

3D FLAIR imaging permits detection of small high-signal-intensity abnormalities within the drainage territory of DVAs. The size of high-signal-intensity abnormalities increased with patient age.