高分辨血管壁MRI在颅内动脉疾病中的诊断价值

Diagnostic value of high resolution vascular wall magnetic resonance imaging in intracranial arterial disease

目的探讨高分辨血管壁磁共振成像(high resolution vessel wall magnetic resonance imaging,HRVW-MRI)在颅内动脉多种疾病中的诊断价值。方法选取颅内动脉壁高分辨磁共振检查的135例患者,经临床对症治疗及与DSA和临床诊断结果对照。结果由影像科2名主治医师初步诊断,1名副主任医师及1名主任医师审核,135例患者中,颅内动脉瘤24例,颅内动脉血栓,不稳定斑块30例,动脉炎15例,变异10例,动脉夹层12例,烟雾病10例,颅内动脉粥样硬化,纤维斑块,轻度硬化狭窄34例。112例(82.9%)MRI检查与DSA及临床诊断一致,20例(14.8%)与临床诊断基本一致,3例(2.3%)与临床诊断不一致。结论所以颅内动脉疾病除了DSA、CTA、MRA检查,磁共振高分辨血管壁检查可协助临床提高脑血管病鉴别诊断准确率发挥重要作用。

Objective To investigate the diagnostic value of high resolution vessel wall magnetic resonance imaging in various diseases of intracranial arteries.Methods We retrospectively analysed of 35 patients with high-resolution magnetic resonance imaging of intracranial arterial wall in our Department of Medical Imaging from October 2018 to March 2019,and compared with DSA and clinical diagnosis.Results Initial diagnosis was made by 2 senior doctors in the imaging department and checked by 1 deputy consultant doctor and 1 consultant doctor.Among the 135 patients,there were 24 cases of intracranial aneurysms,30 cases of intracranial arterial thrombosis,and unstable plaque,15 cases of arteritis,10 cases of variation,12 cases of arterial dissection,10 cases of moyamoya disease,intracranial atherosclerosis,fibrous plaque,and 34 cases of mild sclerosis.112 cases(82.9%)with MRI examination was consistent with DSA,and clinical diagnosis,20 cases(14.8%)were basically consistent with clinical diagnosis,and 3 cases(2.3%)were inconsistent with clinical diagnosis.Conclusion In addition to DSA,CTA,MRA,high-resolution vascular wall examination of magnetic resonance can play an important role in clinically improving the accuracy of differential diagnosis of cerebrovascular disease.