脑静脉畸形的MRI表现及其诊断价值

MR Appearances and Its Diagnostic Value in 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。资料与方法搜集经临床手术证实的脑静脉畸形8例进行回顾性分析,所有患者均进行了常规MRI平扫及3D-MOTSA MRA检查。6例行Gd-DTPA增强T1WI,其中3例行3D-MOTSA增强MRA检查。结果小脑4例,额叶、顶叶、枕叶共4例。5例MRI平扫引流静脉为长T1短T2流空信号,3例呈长T1低信号、长T2高信号。扩张的髓静脉为网状及条状长T1低信号、长T2高信号,增强扫描呈“海蛇头”样改变,即多条髓静脉呈辐射状汇入粗大的引流静脉。3D-MOTSA MRA检查显示部分引流静脉,髓静脉显示较少。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,3D-MOTSA增强MRA检查可取代脑血管造影。

Objective To discuss MRI features of cerebral venous malformation （CVM）, and assess the diagnostic value of different sequence. Materials and Methods 8 cases with CVM verified by surgery were analyzed respectively, conventional MRI and 3DMOTSA MRA were performed in 8 cases with CVM. 6 cases were underwent with enhanced MR, and 3 of them were underwent additional 3D CEMOTSA MRA. Results 4 cases were located in cerebellum and 4 cases in frontal lobe, parietal lobe and occipital lobe. On MRI drain veins were demonstrated as hypointensity on T1WI and T2WI in 5 cases, hypointensity on T1WI and hyperintensity on T2WI in 3 cases, dilated medullary veins were shown as hypointensity on T1WI and hyperintensity on T2WI. After enhancement, numerous radiating medullary veins were gathered together into one or two larger drain veins and flowed into superficial or deeper veins, so called ＂Caput Medussa＂ appearance. 3DMOTSA MRA showed partial drain veins, the number of medullary was less depicted. 3DMOTSA CE MRA could show the whole length of drain veins in 3 cases, the number of medullary veins were much depicted. Conclusion MRI could clearly diagnose complications of CVM and fetch up deficiency of cerebral angiography. 3DMOTSA CE MRA could replace of cerebral angiography.