颅内动脉瘤的MR诊断

Diagnosis of MRI in the intracranial aneurysm

目的:探讨MR对颅内动脉瘤的诊断价值,提高颅内动脉瘤MR及临床表现的认识。方法:回顾性分析8例颅内动脉瘤患者的MR及临床表现资料,男3例,女5例,年龄2.5～70岁,平均48.1岁,所有病例均经临床或DSA证实。突发头痛、呕吐4例,双眼视力障碍2例,间歇性头痛、头晕2例。所有患者均行MR平扫及增强扫描。结果:本组8例患者共发现动脉瘤8处,均为单发,位于鞍上池附近,圆形或类圆形,大小约0.7cm×0.5cm×0.6cm～2.2cm×2.4cm×2.5cm不等;信号混杂,T1WI以等、高信号为主,T2WI为低、等或高信号,7例可见附壁血栓;增强扫描病灶信号从内到外表现一定层次感:内部血流强化呈明显高信号,新月形附壁血栓强化不明显或轻度强化,最外层瘤壁成环形强化。结论:作为无创性影像学检查手段,MR对颅内动脉瘤具有重要诊断价值。

Objective：To explore the application values of MRI for intracranial aneurysms,and to improve the understanding of its MRI appearance and clinical findings.Methods：Characteristic MRI appearance and clinical data of 8 patients（include 3 males and 5 females,aged from 2.5 years to 70 years,mean age 48.1 years） with intracranial aneurysms proved by clinics and/or DSA were retrospectively analyzed.The clinical symptoms included headache and vomiting（n=4）,blurred vision（n=2）,intermittent headache and dizziness（n=2）.All patients underwent MR plain and contrast-enhancement scanning.Results：8 intracranial aneurysms were detected,locating near the suprasellar cistern,round or round-like in shape, the size ranged from 0.7 cm×0.5 cm×0.6 cm～2.2 cm×2.4 cm×2.5 cm.All aneurysms revealed heterogeneous signal intensity,dominated by iso-or hyperintensity on T1WI;hypo-,iso-or hyperintensity on T2WI.Mural thrombus were found in 7 cases.The signal of lesions revealed layer＇s appearance from the inner to the outer on the contrast-enhanced T1WI： enhanced blood revealed hyperintensity,mural thrombus revealed crescent with no or mild enhancement,the most outer layer revealed cirlcular enhancement.Conclusion：MRI is the optimal modality in diagnosing intracranial aneurysms as a noninvasive imaging method.