脑发育性静脉异常及其伴发病变的MRI表现

Manifestations of cerebral developmental venous anomalies and its associated lesions in MRI

目的评价脑发育性静脉异常(DVAs)在不同MR序列的表现及其与伴发病变的关系。方法回顾性分析38例DVAs患者的MRI影像表现,分析MRI不同序列DVAs及其伴发病变的影像表现及特征。结果 1例多发DVAs合并多发海绵状血管瘤,1例多发DVAs合并右侧侧脑室出血,3例多发DVAs未合并其他疾病。8例单发DVAs合并单发海绵状血管瘤,5例合并星形细胞瘤,1例合并颅内血肿,19例为单纯单发DVAs。16例DVAs病灶在T1WI呈点、条或小斑片状低信号,15例病灶在T1WI上未见显示;T2WI上16例病灶呈点、条或小斑片状低信号,5例病灶呈条状、片絮样高信号,10例在T2WI上未见显示;19例病灶DWI序列呈斑片状、条状低信号,8例呈等信号;10例行磁敏感加权成像(SWI)的患者中8例呈树枝状低信号,可见典型海蛇头征,2例未显示DVAs病灶;30例行3D-T1WI增强扫描的患者DVAs病灶均可清晰显示,19例显示典型海蛇头征及粗大引流静脉。结论常规MR序列可显示部分DVAs存在的伴发病变,DWI显示DVAs病变优于常规序列,SWI和3D-T1WI增强扫描可准确诊断DVAs并显示引流静脉。

Objective To evaluate the application value of different MR sequences in cerebral developmental venous anomalies （DAVs）, and to explore the relationship between DVAs and its associated lesions. Methods MRI findings in 38 patients of DAVs were analyzed retrospectively. Imaging performance and characteristics of DAVs and its associated lesions in different MR sequences were analyzed. Results In all of the 38 cases, 3 cases were multiple DVAs without associated lesions, 1 case was combined right lateral ventricle hemorhage, 1 case was combined with multiple cavernous hemangioma, 8 cases were single DVAs with solitary cavernous hemangioma, 5 cases were combined with astrocytoma, 1 case was combined with intracranial hematoma, and 19 cases were single DVAs with no comorbidity. DVAs in 16 cases showed strip or small patchy hypo-intensity lesions and 15 cases were not visible on T1WI; 16 cases showed strip or small patchy hypo-intensity, 5 cases showed strip or flocculent hypo-intensity and 10 cases could not seen on T2WI; 19 cases showed patchy or strip hypo-intensity and 8 cases showed iso intensive signal on DWI; 8 of the 10 cases who performed susceptibility weighted imaging （SWI） examination showed dendritic low signal, showing a typical caput medusae sign, 2 cases showed no lesions on SWI; 30 cases underwent 3D-T1WI enhanced scan showed clearly all lesions of DAVs, 19 cases of them showed typical caput medusae sign and large draining veins. Conclusion Routine MR sequence can demonstrate part of the DVAs and associated peripheral lesions, DWI showed lesions of DAVs is superior to routine MR sequence, SWI and enhanced 3D-T1WI can accurately diagnose DVAs and show the venous drainage.