3D磁敏感加权成像在脑静脉畸形诊断中的初步应用研究

目的：评价3D磁敏感加权成像（Susceptibility weighted imaging,SWI）对脑静脉（窦）的显示能力.并评价3D SWI在脑静脉畸形（Cerebral venous malformation,CVM）诊断中的应用价值.方法：选取20例健康志愿者,行头颅3.0T磁共振T1WI、T2WI及3D SWI检查.根据静脉血管显示情况将其分为0～3共4级,评价T1WI、T2WI及SWI中预设的各解剖区域的脑静脉血管图像质量,分析三者之间的统计学差异.回顾分析30例CVM患者的磁共振图像（常规MRI平扫（包括T1WI、T2WI）、3D SWI及T1WI增强）.根据静脉畸形血管显示情况将其分为0～3共4级,评价常规MRI平扫、SWI及增强扫描对CVM的显示情况,分析三者之间的统计学差异.结果：20例健康志愿者,对静脉窦（直窦、上矢状窦、下矢状窦、横窦、乙状窦）、大脑大静脉等较粗大静脉系统的显示,SWI与T1WI及T2WI基本一致,差异无明显统计学意义（P＞0.05）.对大脑深部静脉（大脑内静脉、基底静脉）及细小引流静脉（丘脑纹状体静脉、透明隔静脉、岛静脉）的显示,SWI优于T1WI及T2WI,差异有统计学意义（P＜0.05）.30例CVM患者,常规MRI平扫、SWI及T1WI增强扫描对CVM的显示有明显统计学差异（P＜0.05）,进一步行两两比较分析,SWI与T1WI增强序列之间的差异无明显统计学意义（P＞0.05）,对CVM均获得了较好的显示效果;这两组序列均优于常规MRI平扫,差异有统计学意义（P＜0.05）,对于病灶的细节显示SWI优于T1WI增强.结论：SWI是显示脑静脉较为敏感、可行、有效的方法,可作为常规序列用于了解脑静脉系统情况.SWI对CVM高度敏感,可替代MRI增强作为诊断CVM的首选检查.

Preliminary study of 3D magnetic susceptibility weighted imaging in the diagnosis of cerebral venous malformation

Objective：To evaluate the display ability of 3D susceptibility weighted imaging（SWI） on cerebral veins（sinuses）.And to evaluate the value of 3D SWI in the diagnosis of cerebral venous malformation （CVM）.Methods：Twenty healthy volunteers were examined by 3.0T MR,including T1WI,T2WI and 3D SWI.The vascular image quality of cerebral veins on T1WI,T2WI and SWI images were analyzed on several preset anatomical regions.The display of veins was classified into 4 grades （grade 0～grade 3）.The difference among T1WI,T2WI and SWI in venous display quality was evaluated.Thirty patients of CVM were examined by 3.0T MR,including conventional MRI（T1WI,T2WI）,3D SWI and T1WI contrast-enhanced scan.The display of venous malformations was classified into 4 grades （grade 0～grade 3）.The difference among conventional MRI,SWI and enhanced MRI in displaying CVM was evaluated.Results：In 20 healthy volunteers,SWI,T1WI and T2WI were almost the same in displaying the great cerebral venous system （straight sinus,superior sagittal sinus,inferior sagittal sinus,transverse sinus,sigmoid sinus,the great cerebral vein）.The difference was not statistically significant （P＞0.05）.For the displaying of cerebral deep veins （internal cerebral vein,the basal vein） and small drainage veins （striate vein,the septum pellucidum vein,island vein）,SWI was superior to T1WI and T2WI.The difference was statistically significant（P＜0.05）.In 30 cases of CVM,the display quality of conventional MRI,SWI and T1WI enhanced scan showed significant difference （P＜0.05）,and furthermore comparison between two of them showed that SWI and T1WI enhanced scan obtained consistent display effect.The difference between the two techniques showed no statistical significance （P＞0.05）.The two sequences were better than conventional MRI.The difference was statistically significant （P＜0.05）.SWI showed more details than T1WI enhanced scan.Conclusion：SWI is a more sensitive,feasible and effective method to show cer