脑静脉畸形的MRI诊断

MRI diagnosis of cerebral venous malformation

目的探讨脑静脉畸形的MRI表现,评价各成像序列的诊断价值。方法7例经DSA及手术证实的脑静脉畸形病例,均行常规MRI平扫及轴位增强扫描。4例行三维多层重叠薄块采集(3dimensionalmultioverlappingthinslabacquisition,3D-MOTSA)增强MRA检查。结果病灶位于小脑4例,额叶、顶叶共3例。常规MRI平扫引流静脉为长T1短T2流空信号,扩张的髓静脉为网状及条状长T1低信号长T2高信号,增强呈“水母头”样改变,即多条髓静脉呈辐射状汇入粗大的引流静脉。3D-MOTSAMRA检查显示部分引流静脉,髓静脉显示较少。4例3D-MOTSA增强MRA检查引流静脉全程显示,髓静脉显示数目多。结论MRI能明确诊断脑静脉畸形的合并症,弥补脑血管造影的不足,结合3D-MOTSA增强MRA检查可取代脑血管造影。

Objective To study MRI findings of cerebral venous malformation (CVM), and assess the value of each imaging sequence. Methods MRI and 3D-MRA scanning were performed in 7 patients with CVM comfirmed by DSA and operation. Results The lesion of 4 cases was located in cerebellum, and 3 cases in frontal or top cobe. MRI showed drain veins demonstrated hypointensity on T1WI and T2WI, while medullary veins showed hypointensity on T1WI and hyperintensity on T2WI. After enhancement, numerous radiating medullary veins gathered into one or two larger drain veins and flowed into superficial or deeper veins, demonstrating so-called“ edussa head” appearance. 3D-MOTSA MRA showed partial drain veins, the number of medullary was less. 3D-MOTSA CE MRA could showed the whole length of drain veins, the number of medullary veins were much. Conclusion MRI can not only diagnose the complications of CVM accurately, but also fetch up the deficiency of cerebral angiography. According to the above advantage, 3D-MOTSA CE MRA could replace cerebral angiography.