HRMR-VWI在椎-基底动脉病变诊断中的应用价值

目的探讨高分辨磁共振血管壁成像(high-resolution magnetic resonance vessel wall imaging,HRMR-VWI)在椎-基底动脉病变诊断中的应用价值。方法对52例经CTA/MRA/DSA确诊椎-基底动脉管腔病变的患者,行HRMR-VWI T 1-VISTA序列平扫加增强检查,评估病变段血管壁改变及病因探究。结果52例椎-基底动脉管腔病变患者中,发现24例动脉粥样硬化改变,占46.2%,均表现为偏心性管壁增厚,增强扫描管壁轻度或明显强化;9例原发性中枢神经系统血管炎,占17.3%,表现为管壁向心性增厚,明显强化;12例椎基底动脉夹层,占23.1%,可见内膜瓣,双腔征,夹层开口位置;7例动脉瘤,占13.4%,5例发生于椎动脉,2例发生于基底动脉,HRMR-VWI清晰可见瘤壁厚度及强化特点。结论HRMR-VWI能够为椎-基底动脉病变病因探究、治疗方案制定提供重要信息,是椎-基底动脉病变的重要检查方法。

The value of HRMR-VWI in the diagnosis of vertebral-basal artery disease

Objective To investigate the value of high-resolution magnetic resonance imaging(HRMR-VWI)in the diagnosis of vertebral-basal artery disease.Methods 52 patients with vertebral-basal artery luminal lesions diagnosed by CTA/MRA/DSA underwent HRMR-VWI T 1-VISTA sequence scan and enhanced examination to evaluate the changes of the vessel wall and the etiology.Results Among 52 patients with vertebral-basal artery luminal lesions,24 cases of atherosclerotic changes were found,accounting for 46.2%,both showing eccentric wall thickening,enhanced scanning tube wall mild or marked enhancement;9 cases were primary central nervous system vasculitis,accounting for 17.3%,showing thickening of the wall of the wall,markedly enhanced;12 cases were vertebral basilar artery dissection,accounting for 23.1%,showing visible endocardial flap,double-chamber sign,mezzanine opening position;7 cases were aneurysm,accounting for 13.4%,5 cases occurred in the vertebral artery,2 cases occurred in the basilar artery,HRMR-VWI clearly showed visible tumor wall thickness and enhancement characteristics.Conclusion HRMR-VWI can provide important information for the exploration and treatment of vertebrobasilar lesions,which is an important method for vertebral-basal artery disease.