脑发育性静脉异常的影像学诊断

Cerebral developmental venous anomalies:diagnosis by medical imaging

目的:分析脑发育性静脉异常的CT、MRI和DSA表现,提高对本病的认识。方法:17例脑发育性静脉异常(DVA)患者中15例行MRI检查、CT检查6例、DSA检查4例。对DVA在不同影像检查的表现进行分析,对DVA的部位、分型、引流方式以及合并的其它异常进行探讨。结果:17例患者有21个DVA,其中3例多发,4例患者合并有海绵状血管瘤。21个DVA中幕上7个,幕下14个,根据其位置分为浅型(皮层和皮层下区)12个和深型9个,其引流静脉中单支引流14例,多支引流3例。增强CT、增强MRI和DSA静脉期均能清晰显示其特征性表现既"水母头"状扩张的髓静脉汇入粗大的引流静脉干。结论:增强CT、MRI以及DSA检查均能正确诊断和评价DVA,DSA是诊断DVA并与其它血管畸形鉴别的金标准;多种序列组合使MRI能更全面的评价DVA及其合并的其它脑实质异常,是DVA检查的首选方法。

Objective：To analyzed the appearance of cerebral developmental venous anomaly （DVA） on CT MRI and DSA imaging and to evaluate imaging diagnostic value. Methods：The imaging appearance of 17 DVA cases were analyzed, including MRI imaging in 15 eases, CT in 6 cases and DSA in 4 cases. The location, type, draining vein and others of DVA were evaluated. Results： 17 cases with 21 DVA included supratentorial in 7 and infra tentorial in 14 and 4 case associated CA. The characteristic ＂Caput Medusas＂ imaging appearance of DVA and numerous radiation medullary veins were gathered together into one or two larger drain veins and flowed into superficial or deeper veins were showed on all CT and MRI enhancement imaging or DSA. Condusion：Postcontrast CT, MRI and DSA are effective methods for DVA diagnosis and evaluation, and DSA is the golden standard in differential diagnosis with other vascular malformation. With multi sequence, MRI could be evaluated DVA and associated parenchymal abnormalities overall, it is the most commonly method.