脑发育性静脉畸形的磁共振诊断价值

Diagnostic value of MRI in brain developmental venous anomalies

目的 探讨不同磁共振成像方法对脑发育性静脉畸形的诊断价值.方法 回顾性分析2014年7月至2016年7月本院经MRI诊断为脑发育性静脉畸形（developmental venous anomaly,DVA）的患者25例,所有患者均行磁共振常规T1WI、T2WI、DWI、T2FLAIR序列扫描,3D SWI、3D ASL序列扫描和T1WI增强扫描.结果 25例患者中,23例各有1个DVA,2例有2个DVA,其中幕上15个,幕下小脑半球11个,小脑蚓部1个.7个病灶于T1WI、T2WI、T2FLAIR序列上未显示,SWI及T1WI增强扫描所有病灶均可显示,ASL序列未显示灌注异常.在T1WI、T2WI、T2FLAIR序列,部分患者可显示引流静脉和髓静脉的流空低信号组成的DVA改变;ASL序列无明显灌注改变;SWI和T1WI增强扫描序列显示,所有患者均见髓静脉呈轮辐状或树枝状汇入引流静脉.结论 MRI常规扫描存在一定漏诊率,结合SWI、T1WI增强扫描可明确诊断脑DVA.

Objective To investigate the diagnostic value of different MRI methods in brain developmental venous anoma- lies （DVA）. Methods Twenty five patients with DVA from July 2014 to July 2017 in our hospital were selected in this study and analyzed retrospectively, All cases underwent T1WI, T2WI, DWI, T2FLAIR eonventinal scan, 3D SWI, 3D ASL and T1WI enhanced scan. Results In the 25 patients, 23 cases had 1 DVA, 2 patients had 2 DVA, 15 DVA were on the supra- tentorial, 11 DVA were under the cerebellar hemisphere, and 1 DVA was in the eerebellar vermis. Seven lesions were not shown on the T1WI, T2WI, T2FLAIR sequences, SWI and T1WI enhanced scan showed all lesions and the ASL sequence did not show abnormal perfusion. Draining veins and medullary veins of some patients showed a change of DVA formed by flow void signal in T1WI, T2WI and T2FLAIR sequence. There was no obvious perfusion change in ASL sequence. Enhanced scan of T1WI and SWI showed medullary veins drained into draining veins in spoke-wheel or arborization pattern. Conclu- sion Routine MRI scan has a certain rate of misdiagnosis, when MRI combined with SWI and enhanced T1WI, DVA can be accurately diagnosed.