MR三维颅脑容积成像评估儿童脑静脉窦血栓患者侧支循环的价值

The value of MR three-dimensional cranial volume imaging in evaluating collateral circulation in pediatric patients with cerebral venous sinus thrombosis

目的:探讨三维颅脑容积成像(3D-BRAVO)对儿童脑静脉窦血栓(CVST)患者侧支循环的价值。方法:选择2020年1月-2023年12月我院收治的80例脑静脉窦血栓形成患儿,所有患儿均确诊为CVST,对所有患儿均进行飞跃磁共振静脉成像(TOF-MRV)、相位对比法静脉血管成像(PC-MRV)、3D-BRAVO序列增强扫描,通过ROC曲线,对比几种检测方法的诊断效能。结果:通过多种影像学检查方式进行综合评估得出,80例患儿单发29例,两处21例,三处17例,四处8例,五处3例,六处2例。存在血栓的静脉窦节段152个,其中上矢状窦30个,直窦15个,右横窦30个,左横窦32个,右乙状窦31个,左乙状窦14个;80例CVST患儿中,TOF病变发现率76.25%,PC-MRV病变发现率78.75%;3D-BRAVO增强成像病变发现率100%;三种诊断方法均对CVST有一定的诊断效能,其中TOF诊断灵敏度为89%,特异度为59%,PC-MRV诊断灵敏度为85%,特异度为70%,3D-BRAVO诊断灵敏度为94%,特异度为71%,其AUC为0.893,高于TOF(0.712)和PC-MRV(0.846)。结论:3D-BRAVO增强扫描序列在儿童CVST中病变发现率为100%,相较于TOF序列和PC-MRV序列而言,其病变发现率更高,诊断效能更佳,可更好的显示静脉窦血栓真实形态和解剖结构,可为临床诊断提供参考依据。

Objective:To explore the value of three-dimensional brain volume imaging(3D-BRAVO)in assessing collateral circulation in children with cerebral venous sinus thrombosis(CVST).Methods:Eighty children with cerebral venous sinus thrombosis admitted to our hospital from January 2020 to December 2023 were selected,all of whom were diagnosed with CVST.All patients underwent skip magnetic resonance venous imaging(TOF-MRV),phase contrast venous angiography(PC-MRV),and 3D-BRAVO sequence enhancement scanning.The diagnostic efficacy of several detection methods was compared through ROC curves.Results:Through comprehensive evaluation using various imaging examination methods,it was found that there were 29 cases of single infection,21 cases in two locations,17 cases in three locations,8 cases in four locations,3 cases in five locations,and 2 cases in six locations in 80 pediatric patients.152 segments of venous sinus with thrombosis,including 30 superior sagittal sinus,15 straight sinus,30 right transverse sinus,32 left transverse sinus,31 right sigmoid sinus,and 14 left sigmoid sinus;Among 80 children with CVST,the detection rate of TOF lesions was 76.25%,and the detection rate of PC-MRV lesions was 78.75%;The detection rate of lesions in 3D-BRAVO enhanced imaging is 100%;All three diagnostic methods have certain diagnostic efficacy for CVST,among which TOF has a sensitivity of 89%and specificity of 59%,PC-MRV has a sensitivity of 85%and specificity of 70%,3D-BRAVO has a sensitivity of 94%and specificity of 71%,and its AUC is 0.893,which is higher than TOF(0.712)and PC-MRV(0.846).Conclusion:The detection rate of lesions in pediatric CVST using 3D-BRAVO enhanced scanning sequence is 100%.Compared to TOF sequence and PC-MRV sequence,it has a higher detection rate and better diagnostic efficacy.It can better display the true morphology and anatomical structure of venous sinus thrombosis and provide reference for clinical diagnosis.