脑发育性静脉异常的影像学表现及诊断价值(附18例分析)

目的:分析脑发育性静脉异常(DVA)的影像学表现和诊断价值,提高对脑DVA的认识水平。方法:回顾分析18例脑DVA的CT和MRI资料,并复习近十年国内外文献,探讨脑DVA的CT、MRI和DSA表现及其在诊断脑DVA中的价值。结果:18例MRI增强扫描共显示19个病灶,由增粗引流静脉及其汇入的扩张小髓静脉组成,形态多样。4个病灶CT平扫均为阴性,3个病灶MRI平扫为阴性,16个病灶MRI平扫信号表现多样。额叶和小脑半球各占5个病灶和6个病灶。由单条引流静脉汇入脑浅或深静脉分别为12个病灶和4个病灶,由2条方向相反的引流静脉同时汇入脑浅深静脉为3个病灶。10例3D-TOFMRA脑动脉系统未见异常,仅2例显示粗大引流静脉。病变区合并海绵状血管瘤者2个病灶,合并出血者1个病灶。结论:增强MRI可根据髓质静脉和引流静脉的显示而作出明确诊断,优于CT、MRI平扫和MRA而可代替DSA,可视为目前诊断脑DVA的最佳影像学方法。

Imaging manifestation and diagnostic value of cerebral developmental venous anomaly:a report of 18 cases

Objective To analyze the manifetation and diagnostic value of cerebral developmental venous anomaly(DVA) and provoke overall clinical cognition.Method Cerebral CT and MRI findings in 18 cases with DVA were retrospectively reported and the related literature within recent 10 years were reviewed.CT,MRI and DSA features were examined and diagnostic value of cerebral DVA were compared.Results Nineteen foci with DVA composed of draining veins and medullary veins in 18 cases were found on enhanced MRI.Four foci on plain CT and 3 foci on conventional MRI were respectively negative.Sixteen foci on plain MRI showed different signal intensities.Five foci were located in front lobe and 6 foci were in the cerebellar hemisphere.Nineteen draining veins included superficial in 12 foci,deep in 4 foci as well as both superficial and deep veins in 3 foci.Cerebral artery system was normal in 10 cases on MR angiography used by three dimensional time of fly(TOF) method except for 2 cases showing wide draining veins.Two foci were accompanied with spongy angioma and 1 focus with hemorrage.Conclusion According to the appearance of dilated draining veins and medullary veins,the enhanced MRI may make correct diagnosis.Enhanced MRI can be considered as a best diagnostic method for DVA,which is superior to CT,plain MRI as well as MRA and can take the place of DSA examination.