脑膜瘤血供的影像学对比研究

Comparative study of blood supply in meningioma imaging

目的通过数字血管减影(Digital subtract angiography,DSA)和多层螺旋CT血管成像(Multi-slice CT angiography,MSCTA)、三维增强磁共振血管造影(3D contrast enhanced MRA,3D CE-MRA)对脑膜瘤血供的对比观察,探讨在三种成像方法的应用价值。方法 51例脑膜瘤患者同时行3D CE-MRA和MSCTA两种方法检查,20例脑膜瘤患者同时行DSA和MSCTA检查,影像结果进行对比观察。结果 MSCTA在供血动脉的来源、走行、静脉回流等达到DSA的显示结果,在瘤体与颅骨、周围大血管等三维立体关系中具有显著优势;3D CE-MRA在静脉窦的显示中最佳,在瘤体、供血动脉及周围血管的关系也有良好的显示,但细小血管分支等显示较差;DSA作为血管成像的"金标准",动脉、静脉和静脉窦都可以良好的显示,但常规造影难以达到完全染色的程度。结论 MSCTA与3D CE-MRA两种无创性血管成像方法均能对脑膜瘤血供特点进行准确的评估;MSCTA空间分辨率高,对血管的细小分支方面显示优于3D CE-MRA,3D CE-MRA在显示引流静脉及静脉窦方面因无骨质干扰及部分容积效应而具有优势。

Objective To compare the image results of blood supply of meningioma by digital subtraction angiography, multislice CT angiography and three-dimensional enhanced magnetic resonance angiography, and explore the application value of the three methods. Methods 51 patients with meningioma underwent 3D CE-MRA and MSC-TA examinations, and 20 patients with meningioma underwent DSA and MSCTA examinations, whose imaging results were compared. Results MSCTA shared the same results with DSA in the source of arteries supply and the venous return, and had the advantage of presenting the three dimensional relationship between tumor and large blood vessels or skull. 3D CE-MRA showed the best image quality in venous sinus, and clearly displayed the relationship between tumor and blood vessels or blood supply arteries, but showed poor image quality in small blood vessels branch. DSA, the＆quot;gold standard＆quot;of vascular imaging, showed the best image quality in arteries, veins and venous sinus, but the con-ventional angiography was difficult to dye fully. Conclusion As noninvasive vascular imaging methods, both MSCTA and 3D CE-MRA could evaluate the blood supply of meningioma accurately. Compared to 3D CE-MRA, MSCTA dis-played higher spatial resolution and had advantages in presenting small branches of vessels. 3D CE-MRA had advan-tages in showing the venous drainage and sinus because there were no bone interference and partial volume effect.