颈内动脉夹层及其治疗转归的MRI表现

MRI Manifestations of Internal Carotid Artery Dissection and Its Treatment Outcomes

目的探讨颈内动脉夹层(ICAD)及其治疗转归的MRI表现。方法收集2007年11月-2013年2月20例ICAD患者治疗前后的MRI资料,分析其MRI表现。结果 ICAD表现:血管狭窄17例,壁间血肿或血栓16例,瘤样扩张3例,内膜片显示2例。治疗转归:①治疗有效18例,其中血管狭窄消失9例(52.9%)、减轻8例(47.1%),血肿或血栓减小13例(81.3%)、消失3例(18.7%);瘤样扩张缩小1例。②治疗无效:瘤样扩张不变2例。另外2例血管狭窄治疗缓解同时,瘤样扩张显示。结论颈内动脉夹层MRI主要表现为血管狭窄、壁间血肿或血栓、瘤样扩张,治疗后血管狭窄、壁间血肿或血栓消失或减轻明显,同时在治疗过程中其表现可互相转换。

Objective To investigate the MRI manifestations of internal carotid artery dissection （ICAD） before and after treatment. Methods MRI materials of 20 patients with ICAD between November 2007 and February 2013 were collected for analysis. Results MRI manifestations of ICAD showed 17 cases of artery stenosis, 16 cases of mural hematoma or thrombus, 3 cases of aneurysmal dilatation, and 2 cases of lines of intimal flap. The treatment outcome MRI manifestations showed that 18 patients had effective response, including disappeared （n--9） and lessened （n=8） artery stenosis, disappeared （n=13） and diminished （n=3） hematoma and thrombus, and shrunken aneurysmal dilatation （n=l）; and there were 2 cases of unchanged aneurysmal dilatation, and another 2 patients had aneurysmal dilatation while stenosis lessened. Conclusions MRI manifestations of internal carotid artery dissection mainly include stenosis, mural hematoma or thrombus, and aneurysmal dilatation. Stenosis, mural hematoma or thrombus usually disappear and lessen in the treatment, and all MRI findings may vary among each other.