脑血管畸形的CT、MRI及MRA诊断(附16例报告)

CT,MRI and MRA of Cerebrovascular Malformations (Report of 16 cases)

目的 探讨CT、MRI及MRA在脑血管畸形中的诊断价值。方法 搜集经血管造影和手术病理证实的脑血管畸形 16例 ,包括动静脉畸形 (AVM ) 12例 ,海绵状血管瘤 4例。所有病例均行CT、MRI平扫及MRA检查 ,MRA采用 3D -TOF法。结果 AVM的CT平扫主要表现为低、等或高混杂密度 ,部分伴钙化 ,合并急性出血者呈高密度。MRI扫描T1WI、T2 WI上呈迂曲扩张畸形血管团的流空影 ,血肿表现多样化。MRA显示供血动脉、引流静脉良好。海绵状血管瘤CT平扫见等、高混杂密度 ,多样化钙化。MRI有其典型表现 ,外周低信号环围绕中央“桑葚状”混杂信号 ,MRA未显示畸形血管。结论 CT、MRI及MRA在诊断脑血管畸形中各有不同诊断价值。联合运用和综合分析 ,可提高诊断准确率 ,较全面地评价脑血管畸形。

Objective To evaluate the value of CT,MRI and MRA in cerebrovascular malformations.Methods 16 cases of cerebrovascular malformations were confirmed by angiography and pathology,including 12 cases of arteriovenous malformations,4 cases of cavernous angiomas. All of these cases were performed with CT,MRI noncontrast scan and 3D-TOF MRA.Results CT appearances of AVM were mixed density with hypodensity,isodensity or hyperdenity.Some had carification or acute hemorrhage.MRI scan showed the dilated and tortuous nidus of AVMs on T 1WI and T 2WI.The appearances of hemorrhage were variable.Feeding arteries and draining veins were showed clearly on MRA.The typical sign of cavernous angiomas was mixed signals with hypointensity ring on MRI,while MRA could not provide much information.Conclusions CT,MRI and MRA had different value in diagnosis of cerebrovascular malformations.CT combined with MRI and MRA could sharply improve the accuracy of diagnosis,and aid in the comprehensive evaluation of cerebrovascular malformations.