3T MR囊内“血管征”对血管周围间隙的定性诊断价值

The Diagnostic Value of Vascular Sign of 3T MR in Cystic Brain Lesions in the Perivascular Space

目的采用3 T MR T2WI、TOF MRA研究在≥5 mm扩张的血管周围间隙(EPVS)及慢性腔隙性梗死(CLI)中'血管征'的出现率,并探讨其鉴别诊断价值。方法搜集110例脑内有≥5 mm的囊性病灶患者,均行T2WI、TOF MRA检查,其中92例分别纳入EPVS组和CLI组,由2名影像医师分别行盲法评估其T2'血管征'、TOF'血管征',并采用统计学方法进行检验。结果 48例51个病灶纳入EPVS组,49例50个病灶纳入CLI组(其中5例同时合并EPVS和CLI),101个病灶中有79个位于基底节区(78.2%)。EPVS中的T2'血管征'和TOF'血管征'的出现率均明显高于CLI(P<0.001)。与T2'血管征'相比,TOF'血管征'对于诊断EPVS具有更高的特异度(100%)和准确率(84.2%、83.2%)(P<0.001)。结论在EPVS和CLI病灶内,T2'血管征'、TOF'血管征'均为常见征象。该征象对于基底节区EPVS和CLI的鉴别诊断具有重要的临床意义。TOF'血管征'可作为EPVS诊断的特征之一。

Objective The occurrence rate of 3 T MR T2WI and TOF MRA'vascular signs'was studied in the enlarged perivascular space(EPVS)and chronic lacunar infarction(CLI),which was greater than 5 mm,and the value of differential diagnosis was discussed.Methods This study included 110 patients with cystic lesions≥5 mm on brain MRI including TOF MRA in which 92 cases were divided into the EPVS and CLI group respectively.Two imaging experts evaluated their T2'vascular signs'and TOF'vascular signs'respectively,and used statistical methods to test them.Results A total of 48 patients with 51 lesions were included in the EPVS group,and 49 patients with 50 lesions were included in the CLI group,and of the 101 lesions,79 were in the basal ganglia(78.2%).The occurrence rate of T2'vascular signs'and TOF'vascular signs'in EPVS was significantly higher than that of CLI(P<0.001).Compared with T2'vascular sign',TOF'vascular sign'has higher specificity(100%)and accuracy(84.2%,83.2%)(P<0.001)for the diagnosis of EPVS.Conclusion In EPVS and CLI lesions,T2'vascular signs'and TOF'vascular signs'were common signs.This sign has important clinical significance for the differential diagnosis of EPVS and CLI in the basal ganglia region.TOF'vascular sign'can be used as one of the characteristics of EPVS diagnosis.