MRI和MRV诊断脑静脉性血管畸形的价值

目的探讨MRI和MRV诊断静脉性血管畸形的价值。方法收集经MRI诊断的12例脑静脉性血管畸形病例，其中3例具备MRV资料，分析其MRI和MRV表现。结果脑静脉性血管畸形发生于额叶4例，顶叶3例，基底节区2例，小脑3例。合并海绵状血管瘤4例，合并Chairi畸形1例，合并出血3例。脑静脉性血管畸形在MRI上可见典型表现，平扫时脑静脉性血管畸形的导静脉在T1W及T2WI上均呈血管流空信号，髓静脉多数显示不佳，T1WI为等信号或稍低信号，T2WI为等信号或稍高信号。增强后可清晰显示多条髓静脉呈辐射状汇人粗大的导静脉，呈“海蛇头”样之典型改变。MRV可显示异常扩张之导静脉，并可显示其回流归属，对髓静脉显示不佳。结论MRI能可靠检出病灶，具备特征性表现，并能明确诊断脑静脉畸形的合并症，MRV可直观而形象地显示引流静脉及其回流方向，类似于脑血管造影表现，能弥补MRI的不足。

Evaluation of MRI and MRV in the diagnosis of cerebral venous malformation

Objective To investigate the value of MRI and MRV in the diagnosis of cerebral venous malformation （CVM）. Methods MRI were performed on 12 cases with CVM and MRV were performed on 3 of them. The MRI and MRV manifestations were analyzed. Results There were 4 lesions located in frontal lobe, 3 in parietal lobe, 2 in basal ganglia, 3 in cerebellum 4 of them combined with cerebral cavernous malformations, 1 with Arnold-Chiari anomaly, 3 with cerebral hemorrhage. Cerebral venous malformation （CVM） has typical MRI representations. On plain MRI drain veins demonstrated flow void signal on T1W and T2WI, while medullary veins unclearly showed, which were iso-intensity or slightly low-intensity on T1WI, iso-intensity or slightly high-intensity on T2WI. After enhancement, numerous radiating medullary veins gathered into larger drain veins, demonstrating typical ＂Caput medussa＂ appearance. MRV could show abnormal dilated drain veins. Conclusion It is reliable for MRI to display the characteristic performance and complications of CVM. Drain veins could be showed on MRV, similar to cerebral angiographyl.