磁敏感加权成像在脑静脉血管畸形中的应用价值

Value of susceptibility weighted imaging in the diagnosis of cerebral venous malformations

目的探讨磁敏感加权成像(SWI)在脑静脉血管畸形(CVM)中的诊断价值。方法回顾分析淮安市洪泽区人民医院2012年6月至2016年12月收治的36例CVM患者的影像资料,所有患者均行常规MRI平扫、静脉注射GD-DTPA增强、SWI加权成像,6例行CT平扫。结果 36例共发现37个CVM病灶,另有3例伴发海绵状血管瘤(CCM),SWI序列均得到明确显示,TIWI发现病灶25个,T2WI发现病灶28个,增强扫描所有CVM病灶都能够显示,但只显示明显扩张的髓静脉及增粗的引流静脉,而SWI明确显示所有扩张的髓静脉成放射状汇入增粗的引流静脉,呈典型的"水母头"征,对3例伴发海绵状血管瘤亦能够明确显示,病灶周围铁环征较常规MRI明显增宽。结论 SWI能够明确显现CVM特征"水母头"样表现,并且无需注射对比剂清晰显现细小髓静脉,是目前诊断脑静脉血管畸形的重要检查方法。

Objective To explore the diagnostic value of susceptibility weighted imaging（SWI） in cerebral venous malformations（CVM）, Methods The imaging data of 36 patients of CVM from June 2012 to December 2016 in our hospital were reviewed. All patients underwent routine MRI, Gd-DTPA enhanced scan, and SWI. Six patients received CT scans as well. Results A total of 37 CVM lesions were found in the 36 patients, and 3 patients were complicated with cavernous hemangiomas（CCM）. All the lesions were showed in SWI, and 25 lesions were detected in T1 WI and 28 in T2 WI. Enhanced MRI showed all the lesions with images of enlarged medullary veins and draining vein, while SWI clearly showed all the lesions with enlarged medullary veins and draining vein expressed as a paradigm of＂caput medusae＂. The three cases of cavernous hemangiomas were showed clearly in SWI in which＂ironcircle＂sign surrounding the foci was obviously enlarged than that showed in routine MRI. Conclusion SWI can clearly display image features of CVM, detect more small venous drainage without contrast media, and is an important method for the diagnosis of CVM.