MRI对脑静脉畸形的诊断价值

Diagnostic value of MRI in cerebral venous malformation

目的:探讨MRI对脑静脉畸形(CVM)的诊断价值。方法:收集本院18例脑静脉畸形病例,均行磁共振T1WI、T2WI、FLAIR、SWI、DWI、MRA及T1WI增强扫描的资料。结果:CVM位于幕下5例,幕上13例,18例均呈典型的"海蛇头"征。MRI显示髓静脉呈长T1长T2信号,引流静脉呈短T1稍长T2信号或长T1长T2信号。FLAIR上髓静脉为稍高信号,引流静脉为低信号或稍高信号。SWI及DWI上髓静脉和引流静脉均为低信号。增强呈"海蛇头"样改变,即多条髓静脉呈辐射状汇入粗大的引流静脉。结论:MRI能明确诊断脑静脉畸形,T1WI增强扫描及SWI均较敏感。SWI对CVM的诊断价值明显优于常规MRI序列。

Objective：To investigate the diagnostic value of MRI in cerebral venous malformations（CVM）.Methods：18 patients of CVM were collected,and all of them underwent T1WI,T2WI,FLAIR,SWI,DWI,MRA,and T1WI enhancement scans.Results：CVMs were located in infra in five cases,and supra tentorium in thirteen eleven patients.Eighteen presented the typical ＂caput medusae＂ appearance.As for MRI plain scans,the medullary veins showed hypointensity in T1WI and hyperintensity in T2WI,while,the drainage veins featured hyperintensity in T1WI and hyperintensity in T2WI.FLAIR sequences manifested less medullary veins with hyperintensity and drainage veins with hypointensity or hyperintensity.Both the medullary and the drainage veins appeared hypointensity in DWI and SWI.After enhancement,numerous radiating medullary veins gathered together into one or two larger drainage veins and flowed into superficial or deeper veins,demonstrating the so-called ＂Caput Medusae＂ appearance.Conclusion：MRI is the first choice for suspected CVM patients thus providing more diagnostic information.T1WI enhancement and SWI are sensitive to manifesting CVMs.SWI diagnosis of CVM is significantly superior to conventional MRI sequences.