3.0T磁共振SWI序列对脑淀粉样血管病的诊断价值

The Value of 3.0T MR Susceptibility Weighted Imaging in Diagnosing Cerebral Amyloid Angiopathy

目的探讨SWI序列对脑淀粉样血管病(CAA)的诊断价值。方法回顾性分析10例影像学证据高度怀疑CAA的病例,对其常规MRI及SWI图像进行分析。结果 10例中,全部表现为SWI上皮层-皮层下多发类圆形低信号,边界清楚,其中2例在T2WI图像相应位置上见数个点状低信号,数目少于SWI上所见,余8例SWI低信号灶在常规MRI序列上未见显示;6例合并小脑半球陈旧性出血,合并基底节、丘脑、脑干陈旧性出血各2例,3例合并脑叶亚急性及陈旧性出血。结论 SWI显示CAA皮层及皮层下的多发微出血灶有助于CAA的早期诊断并指导临床治疗。

Objective To investigate the diagnostic value of susceptibility weighted imaging in cerebral amyloid angiop- athy（CAA）. Methods The SWI images of 10 patients of CAA highly suspected by MRI features were analysed retrospec- tively, which were compared to conventional magnetic resonance imaging. Results All the 10 cases demonstrated diffuse microhaemorrhages at the grey white matter junction in a lobar distribution that were not seen on conventional MRI se- quences except for 2 case, which several small hypointense lesions were detected on T2WI image. There were 6 of 10 cases concomitanting with microbleedings in the cerebellar hemisphere, 2 cases in the basal ganglia, 2 cases in thalamus and 2 cases in the brain stem. 3 cases represented sub acute and chronic cerebral bleeding. Conclusion The distribution of small cerebral microbleedings at the grey white matter junction detected on SWI images may lead to earlier diagnosis of patients with CAA and assist in clinical treatment.