应用3.0T MRI评价缺血性脑血管病与鼻窦炎性病变的关系

Association between ischemic cerebrovascular disease and nasosinusitis evaluated by 3.0T MRI

目的:应用3.0TMRI从影像学角度探讨缺血性脑血管病与鼻旁窦炎性病变的关系及鼻旁窦炎性病变的MRI表现。方法:①分组及检测:2006-10/2007-08河北医科大学第二医院收治经临床及影像学证实为缺血性脑血管病患者218例为病例组,健康体检者218例为对照组,应用美国GE公司Signa Excite HD 3.0T高场强MR扫描仪常规行MRI及MRA检查。②评估指标:MRI图像观察以轴位T2-FSE、轴位T1-FLAIR序列为主,辅以轴位T2-FLAIR、矢状位T1-FLAIR序列,观察并记录脑实质MRI表现、鼻旁窦有无炎性病变。MRA图像观察以MIP重组后图像为主,辅以MRA源图像,观察并记录颅内血管异常情况。主要观察指标包括额窦、筛窦、蝶窦、上颌窦受累情况,各窦病变类型(黏膜增厚、炎性积液、黏膜下囊肿)及相应的MRI表现。结果:①病例组所有患者前循环及后循环系统血管均存在不同程度的动脉粥样硬化改变,143例患者脑实质出现缺血性病变;对照组脑实质及脑血管均未见异常改变。②病例组鼻旁窦有病变者123人次(56.4%),上颌窦病变96例,筛窦病变58例,蝶窦病变30例,额窦病变15例;对照组鼻旁窦有病变者54人次(24.8%),上颌窦病变8例,筛窦病变34例,蝶窦病变2例,额窦病变4例。病例组鼻旁窦炎性病变明显较对照组多(χ2=45.281,P=0.000)。相关系数C=0.91。结论:缺血性脑血管病患者鼻旁窦炎性病变发病率高,缺血性脑血管病与鼻旁窦炎性病变间有一定的相关性。

AIM： To investigate the association between ischemic cerebrovascular disease and nasosinusitis and explore the MRI manifestation of nasosinusitis by 3.0T MRI. METHODS： （1）218 patients with ischemic cerebrovascular disease, who were diagnosed by clinic and imaging, were selected from the Second Hospital of Hebei Medical University between October 2006 and August 2007 as case group. Meanwhile, 218 healthy volunteers were selected as controls. The MRI and MRA images were observed by Signa Excite HD3.0T high field MR scanner （GE, U.S.A）. （2）With the sequence including axial T2-FSE and axial T1-FLAIR, assisted by axial T2-FLAIR and sagittal T1-FLAIR, the abnormity of paranasal sinus was observed and recorded. With MIP reorganized images assistant by MRA image, the appearance of brain and cerebral vessels was observed. The main indexes included the condition of frontal antrum, ethmoid sinuses, sphenoid sinus and maxillae antrum that was involved in, the types of the inflammation （mucous thickening, inflammatory fluidify and submucosal cyst） and its MRI appearance. RESULTS： （1）The cerebral vessels of all subjects in the case group presented atherosclerosis in different degrees, and the brain parenchyma of 143 subjects presented ischemic changes. The brain and cerebral vessels were normal in the control group. （2）In the case group, 123 subjects （56.4%） had nasosinusitis, and the number of the abnormity in the maxillae antrum, ethmoid sinuses, sphenoid sinus and frontal antrum was 96, 58, 30 and 15, respectively. In the control group, 54 subjects （24.8%） had nasosinusitis, and the number of the abnormity in the maxillae antrum, ethmoid sinuses, sphenoid sinus and frontal antrum was 8, 34, 2 and 4, respectively. Nasosinusitis in the case group was significantly more and severer than the control group （x^2=45.281, P =0.000）. The correlation coefficient was 0.91. CONCLUSION： The incidence of nasosinusitis in patients with ischemic cerebrovascular disease is high, indicating there is certain association between ischemic cerebrovascular disease and nasosinusitis.