磁敏感加权成像技术对儿童脑血管畸形的诊断价值

Diagnostic value of susceptibility weighted imaging in cerebral vascular malformations of children

目的:探讨磁敏感加权成像技术(SWI)对儿童脑血管畸形的临床诊断价值。方法:选取2013年7月至2015年3月温州医科大学附属第二医院育英儿童医院脑血管畸形患儿38例,分别行常规MRI和SWI检查,其中动静脉畸形11例、脑静脉畸形8例、海绵状血管瘤14例(其中多发5例、单发9例)和毛细血管扩张症5例,7例同时行钆喷酸葡胺增强扫描,比较常规MRI序列与SWI序列对脑血管畸形病灶检测的差异。结果:38例脑血管畸形病灶在SWI均清晰显示。动静脉畸形、海绵状血管瘤、脑静脉畸形、毛细血管扩张症的常规MRI检出率分别为100.0%、78.6%、37.5%和20.0%,而SWI检出率均为100.0%。SWI在显示微出血、引流静脉及髓静脉方面明显优于常规MRI。结论:SWI在儿童脑血管畸形疾病中较常规MRI更多、更清晰地显示病灶情况,避免部分病灶的漏诊,在儿童脑血管畸形诊断中具有重要的临床价值。

Objective:To evaluate the diagnostic value of susceptibility weighted imaging(SWI)in cerebralvascular malformations of children.Methods:Thirty eight cases of cerebral vascular malformationsof children underwent routine magnetic resonance imaging(MRI)and SWI examination,which included11cases of arterio-venous malformations(AVM),8cases of cerebral venous malformations(CVM),14cases ofcavernous hemangiomas(9cases of solitary and5cases of multiple)and5cases of intracerebral capillary telangiectasia(ICT).Seven cases performed routine gadopentetate dimeglumine(Gd-DTPA)enhanced MRI scan.The difference of SWI and conventional MRI sequences on detection of cerebral vascular malformations wascompared.Results:Thirty eight cases of cerebral vascular malformations were well-displayed on SWI.The detectionrate of conventional MRI in AVM,cavernous hemangiomas,CVM and ICT were100.0%,78.6%,37.5%and20.0%respectively.While the detection rate of SWI in them were all100.0%.SWI was obviously superiorto conventional MRI on demonstrating microbleed foci,draining veins and medullary veins of cerebral vascularmalformations.Conclusion:Comparing with conventional MRI,SWI can clearly show more details and detectmore small lesions of cerebral vascular malformations,and avoid the missed diagnosis.It has an importantvalue for the diagnosis and differentiation diagnosis of cerebral vascular malformation in children.