3.0T磁共振血管造影普查对颅内动脉开窗畸形的诊断价值

Diagnostic value of 3.0 T magnetic resonance angiography screening in intracranial artery fenestration

目的通过大样本病例研究颅内动脉开窗畸形磁共振血管造影（MRA）的检出率、好发部位及其临床意义。方法2009年10月至2011年3月行MRA 2 036例患者,确诊动脉开窗畸形25例（开窗畸形组）,其中男性14例,女性11例;年龄30~81岁,平均年龄60.5岁。全部行头颅三维时间飞跃MRA（3D-TOF MRA）扫描,将原始图像经工作站处理,得到最大密度投影（MIP）和容积重组（VR）图像,分析颅内动脉开窗畸形的影像学特点,与伴发动脉瘤之间的相关性。结果 2 036例患者中,发现动脉开窗畸形共计25例（检出率1.23%,25/2 036）,其中位于基底动脉11例;位于椎动脉颅内段4例;位于前交通动脉区6例;位于大脑中动脉3例;位于大脑后动脉1例。25例开窗畸形中有6例合并动脉瘤,4例位于颈内动脉颅内段,2例位于大脑前动脉。结论 3D-TOF MRA检查能准确诊断、显示颅内动脉开窗畸形。

Objective To explore the detection rate,common location and clinical significance of intracranial artery fenestration by a large sample cases.Methods From October 2009 to March 2011,25 of 2 036 patients enrolled three dimensional time of flight（3D-TOF） magnetic resonance angiography（MRA） were,diagnosed artery fenestration（fenestration group）,male 14,female 11,aged 30-81 years old,mean age 60.5 years old.The reconstructed images were processed by maximal intensity projection（MIP） and volume rending（VR） techniques.The imaging feature of intracranial arteries fenestration and correlation between aneurysm were analyzed.Results Twenty-five（1.23 %,25/2 036） fenestrations of intra and extracranial artery were detected.In 25 fenestrations,11 were located in basilar artery,4 in intracranial vertebral artery,6 in anterior communicating artery,3 in middle cerebral artery,1 in posterior cerebral artery.Six cases combined with aneurysms,4 were located in intracranial internal carotid artery and 2 in anterior cerebral artery.Conclusion It is demonstrated that 3D-TOF MRA could diagnose and display accurately the intracranial artery fenestration.