磁共振时间飞跃法血管成像与磁敏感成像在脑血管畸形中的影像学比较研究

目的 通过分析脑动静脉畸形和海绵状血管瘤的的时间飞跃法磁共振血管成像(3D-TOFMRA)及磁敏感加权成像(SWI)磁共振表现,探讨3D-TOF-MRA与SWI对两种常见脑血管畸形的诊断价值.方法 对我科收治的44例血管畸形进行磁共振成像,并加扫3D-TOF MRA及SWI序列,其中26例海绵状血管瘤、18例动静脉畸形.分析比较二者对脑血管畸形的检出率以及细微特征的鉴别能力.结果 3D-TOF MRA可以清晰显示动静脉畸形的部位、大小、输入动脉的来源、输出静脉的去向;海绵状血管瘤MRA成像未见明显供血动脉.SWI清晰显示海绵状血管瘤的数目及范围较常规序列增大;而且还能显示动静脉畸形迂曲的小静脉,但不能直观显示畸形血管团的全貌及输入动脉等粗大血管的情况.结论 3D-TOF MRA技术对于动静脉畸形之类高流速低阻力的血管畸形的显示具有独特的价值,而SWI技术则对于海绵状血管瘤等低流速小管径的血管畸形的显示具有明显的优势;二者联合可以提高脑血管畸形检出,减少漏诊及误诊.

A comparative imageology study of TOF-MRA and SWI in the diagnosis of intracranial vascularmalformations

Objective To study the imaging of arteriovenous malformation(AVM)and cerebral cavernous angiomas(CCA)by 3D-TOF MRA and SWI.Methods The clinical manifestations and MR imaging characteristics of 44 cases with intracranial vascular malformations were retrospectively analyzed.The MRA imaging and SWI imaging of 26 CCA cases and 18 AVM cases were compared.Results The location,size,input.artery and output vein of arteriovenous fistula were clearly showed by 3D-TOF MRA.3D-TOF-MRA did not show the artery of hemangioma.The imaging of SWI can clear display the number and increase of cavernous hemangioma,comparing with the conventional sequence.Moreover,SWI was effective to show the tortuous veins of arteriovenous malformation.However,it was not able to directly show the overview of abnormal blood vessels and big arteries such as input artery.Conclusion 3D-TOF MRA technologies is powerful to show the arteriovenous malformation with high flow velocity and low resistance(Such as AVM),while SWI has advantages in showing the cavernous hemangioma with low flow velocity and small diameters.Joining 3D-TOF-MRA and SWI techniques will improve the detection of cerebral vascular malformations and reduce the misdiagnosis and missed diagnosis.