磁共振SWI在未破裂脑动静脉畸形隐匿性出血中的应用及文献复习

Application of SWI MRI to diagnosis of occult hemorrhage of unruptured cerebral arteriovenous malformation and review of the literature

目的探讨磁共振磁敏感加权成像(SWI)诊断未破裂脑动静脉畸形(AVM)隐匿性出血的有效性。方法前瞻性搜集2016年1～12月就诊于我院的20例AVM,术前行磁共振常规序列及SWI序列扫描。计算机检索PubMed、Science Direct、中国知网、万方数据等数据库,对未破裂AVM隐匿性出血相关研究进行总结。结果 20例中,5例(25%)隐匿性出血阳性,其中3例为单发,2例为多发。共检索出5篇论著及1篇评论,这些研究均为病理学研究,隐匿性出血阳性率在28.6%～37.0%;常规MRI对隐匿性出血的检出率约为6.6%,高分辨MRI检出率约为20%。结论 SWI在检测未破裂AVM隐匿性出血中具有较高的效能。

Objective To explore the effect of magnetic resonance susceptibility-weighted imaging（SWI） on the detection of silent intralesional microhemorrhage（SIM） of unruptured cerebral arteriovenous malformations（cAVMs）. Methods SWI were performed in 20 patients with unruptured cAVMs in our hospital from January to December, 2016. The literatures related to SIM obtained by searching the PubMed, Web of Science and Science Direct and so on database were reviewed. Results Of these 20 patients aged（24.6±12.5） years, 5（25%） had SIM and 15 not. SIM was single in 3 patients and multiple in 2 patients. The incidence of SIM detected by SWI was consistent with that（about 30%） found by previous histopathological studies in the patients with unruptured c AVMs. The findings on MR SWI could be small round focus or sheet distributions of irregular shape in the patients with SIM of unruptured c AVMs.Conclusions SWI is very helpful to preoperative detection of SIM in the patients with unruptured cAVMs. Further prospective study and long-term follow-up are needed in order to prove the value of SWI to the detection of SIM in the patients with unruptured c AVMs.