磁敏感成像诊断脑血管畸形

Diagnostic Value of Susceptibility-weighted Imaging in Intracranial Vascular Malformation

目的:探讨磁敏感成像对海绵状血管瘤和静脉畸形等脑血管畸形的诊断价值。方法:回顾分析23例经手术病理证实的海绵状血管瘤和静脉畸形患者的磁敏感成像后处理图像及常规T1WI、T2WI及增强T1WI图像。结果:23例脑血管畸形中海绵状血管瘤18例、静脉畸形5例。常规MRI和磁敏感成像均显示18例海绵状血管瘤的出血灶,磁敏感成像上14例呈"铁环"征,常规MRI仅9例见此征象,磁敏感成像显示出血范围较常规MRI大;5例静脉畸形磁敏感成像均显示引流静脉及髓静脉呈条状低信号,髓静脉呈特征性的"海蛇头"状分布,常规MRI仅2例显示此征。结论:磁敏感成像能敏感地显示出血、微出血及细小静脉,与常规MRI结合可显著提高海绵状血管瘤和静脉畸形的检出率。

Objective：To investigate the diagnostic value of susceptibility-weighted imaging （SWI） in cavernous angiomas and venous malformation. Methods：Susceptibility-weighted imaging, conventional T1WI, T2WI and enhanced T1WI data of 23 patients with cavernous angiomas or venous malformation proved by surgery or pathologic results were analyzed retrospectively. Results：23 cases of intracranial vascular malformation including 18 cases of cavernous angiomas and 5 cases of venous malformation were enrolled in the study. In 18 cases of cavernous angiomas,hemorrhage was detected in both susceptibility-weighted imaging and conventional MR sequences. Susceptibility-weighted imaging depicted ＂hypointensity ring＂ in 14 cases,while conventional MRI did only in 9 cases. The area of hemorrhage was larger on susceptibility-weighted imaging than on conventional MRI. In 5 cases of patients with venous malformation, drain veins and pulp veins were clearly shown on susceptibility-weighted imaging. The typical ＂caput medusae＂ appearance was shown on susceptibility-weighted imaging. It was shown in conventional MR1 only in 2 of the 5 cases. Conclusion： Susceptibility-weighted imaging can detect hemorrhage,microbleeding and subtle veins sensitively. The combination of conventional MRI and susceptibility-weighted imaging can significantly improve the detection of cavernous angiomas and venous malformation.