MR对脑静脉血管瘤患者的诊断价值分析

Analysis of value of MRI in diagnosis of patients with cerebral venous angioma

目的:评价MRI对脑静脉血管瘤(VA)患者的诊断价值。方法:回顾性收集MR诊断为VA患者30例,均行常规MR平扫、增强及磁敏感加权成像(SWI)检查,并分析其MR表现。结果:30例VA患者中发生于幕下小脑半球12例,额叶11例,顶叶5例,颞叶1例,基底节区1例;并发海绵状血管瘤2例,左侧颞叶及右侧顶叶各1例;合并出血2例,右侧顶叶及右侧小脑半球各1例;MR平扫显示病灶20例,其中T2WI表现为条状血管流空信号者16例,而表现为放射状高信号者4例;MR增强检查显示所有病灶,并且表现为"海蛇头"样强化特征。SWI检查均能清晰显示所有病灶,表现为典型的"海蛇头"样低信号影。结论:VA多发生于患者小脑半球及额顶叶,可并发海绵状血管瘤;SWI较常规MR序列相比可以更好地显示VA,其能取代MR增强检查用于VA患者的诊断和随访。

Objective: To evaluate value of MRI in diagnosis of cerebral venous angioma( VA). Methods: 30 patients diagnosed as VA based on MR imaging were collected.All patients underwent pre-and post-contrast MRI as well as underwent susceptibility weighted imaging( SWI).The MRI manifestations was analyzedretrospectively.Results: Of the 30 cases with VA,the locations were white matter of cerebellar hemispheres( 12 cases),white matter of frontal lobes( 11 cases),parietal lobes( 5 cases),temporal lobes( 1 case) and basal ganglia( 1 case).VA associated with cavernous hemangiomawas found in2 cases( 1 in left frontal lobe and 1 in right frontal lobe),and VA combined with hemorrhage was seen in 2 cases( 1 in right frontal lobe and 1 in right cerebellar hemisphere). Only 20 lesions were detected on pre-contrast MRI,which demonstrated as linear flow void appearance in 16 cases on T2 WIand as radiated high signal intensity in 4 cases.On contrast enhanced MR imaging,all the lesions showed typical ' caput medusae'-like enhancement.All of cases underwent SWI, ' caput medusae'-like low signal intensity was clearlyassessed.Conclusions: The most common locations of VAs are the white matter of frontal and parietal lobes and cerebellarhemispheres,which can be associated with cavernous hemangioma.SWIis more sensitive to VAs than conventional MR,and can be a substitutive modality for contrast enhanced MR imaging in the diagnosis and follow-up of VA.