磁共振成像技术在小儿脑动静脉畸形中的应用价值
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摘要
目的分析磁共振成像(MRI)常规序列结合磁共振动脉成像(MRA)、磁共振静脉成像(MRV对小儿脑动静脉畸形(AVM)的应用价值。方法回顾性分析46例临床疑诊AVM患儿的临床资料,以数字减影血管造影(DSA)结果为金标准,分析MRI联合MRA及MRV成像技术对本病的应用价值。结果 MRI联合MRA及MRV诊断AVM 29例,经DSA证实共存在AVM 32例。MRI平扫瘤巢呈蜂窝状T_1WI等低、T_2WI高低混杂信号,MRA瘤巢呈高信号畸形血管团,并可见迂曲供血动脉,MRV可见粗大引流静脉汇入横窦或乙状窦;MRI联合MRA、MRV诊断AVM的敏感性为84%,特异性为93%,准确性为88%,与DSA具有高度一致性(kappa值=0.903);MRI联合MRA、MRV的图像质量优24例、良5例、差3例,优良比为91%。结论 MRI常规序列结合MRA及MRV技术可清晰显示AVM的畸形血管解剖关系及周围脑组织情况,并且准确性高、无辐射、无创伤等优势,对小儿颅脑AVM的诊断具有非常重要的作用。
Objective To analyze the application value of routine magnetic resonance imaging(MRI) combined with magnetic resonance arterial imaging(MRA) and magnetic resonance venous imaging(MRV) in children with cerebral arteriovenous malformation(AVM). Methods The clinical data of 46 patients with suspected clinical AVM were retrospectively analyzed, and the application value of MRI combined with MRA and MRV imaging technology to this disease were analyzed with DSA results as the gold standard. Results Twenty-nine cases with AVM were diagnosed by MRI combined with MRA and MRV, and 32 cases with AVM were confirmed by DSA. MRI scan tumor nests were low, T_2WI mixed signals, such as cellular T_1WI arteriolar MRA tumor nests were high signal abnormalities,and visible circuity blood supply arteries, MRV was bulky venous drainage into the transverse sinus and sigmoid sinus; The sensitivity, specificity and accuracy of MRI combined with MRA and MRV in the diagnosis of AVM were84%, 93% and 88%, which were highly consistent with DSA(Kappa value =0.903). The image quality of MRI combined with MRA and MRV was excellent in 24 cases, good in 5 cases and bad in 3 cases, with an excellent ratio of91%. Conclusion MRI combined with MRA and conventional sequence MRV technology can clearly show the AVM malformation vascular anatomic relationship and the surrounding brain tissue, with the advantages of high accuracy,no radiation, no wound, which has a very important role in the diagnosis of infantile cerebral AVM.
Objective To analyze the application value of routine magnetic resonance imaging(MRI) combined with magnetic resonance arterial imaging(MRA) and magnetic resonance venous imaging(MRV) in children with cerebral arteriovenous malformation(AVM). Methods The clinical data of 46 patients with suspected clinical AVM were retrospectively analyzed, and the application value of MRI combined with MRA and MRV imaging technology to this disease were analyzed with DSA results as the gold standard. Results Twenty-nine cases with AVM were diagnosed by MRI combined with MRA and MRV, and 32 cases with AVM were confirmed by DSA. MRI scan tumor nests were low, T_2WI mixed signals, such as cellular T_1WI arteriolar MRA tumor nests were high signal abnormalities,and visible circuity blood supply arteries, MRV was bulky venous drainage into the transverse sinus and sigmoid sinus; The sensitivity, specificity and accuracy of MRI combined with MRA and MRV in the diagnosis of AVM were84%, 93% and 88%, which were highly consistent with DSA(Kappa value =0.903). The image quality of MRI combined with MRA and MRV was excellent in 24 cases, good in 5 cases and bad in 3 cases, with an excellent ratio of91%. Conclusion MRI combined with MRA and conventional sequence MRV technology can clearly show the AVM malformation vascular anatomic relationship and the surrounding brain tissue, with the advantages of high accuracy,no radiation, no wound, which has a very important role in the diagnosis of infantile cerebral AVM.
引文
[1]郑晓娜,付馨,吴耀贤.3.0T MRI多序列成像与MRA在脑动静脉畸形诊断中的应用[J].中国实用神经疾病杂志,2015,18(3):56-58.
[2]张保朋,王道清,程留慧,等.双源CT脑血管成像在脑动静脉畸形诊断及治疗中的价值[J].中国实用神经疾病杂志,2016,19(14):37-39.
[3]Matschke J,Lockemann U,Schulz F.Intracranial arteriovenous malformations presenting as sudden unexpected death:a report of3 cases and review of the lliterature[J].Am J Forensic Med Pathol,2007,28(2):173-176.
[4]Gross BA,Du R.Natural history of cerebral arteriovenous malformations:a meta-analysis:clinical article[J].J Neurosurg,2013,118(2):437-443.
[5]肖艳,吕发金.脑动静脉畸形影像诊断新技术进展值[J].放射学实践,2016,31(5):456-459.
[6]李永丽,闫峰山,窦社伟,等.非对比增强四维MR血管成像评价脑动静脉畸形[J].中国医学影像技术,2013,29(5):701-705.
[2]张保朋,王道清,程留慧,等.双源CT脑血管成像在脑动静脉畸形诊断及治疗中的价值[J].中国实用神经疾病杂志,2016,19(14):37-39.
[3]Matschke J,Lockemann U,Schulz F.Intracranial arteriovenous malformations presenting as sudden unexpected death:a report of3 cases and review of the lliterature[J].Am J Forensic Med Pathol,2007,28(2):173-176.
[4]Gross BA,Du R.Natural history of cerebral arteriovenous malformations:a meta-analysis:clinical article[J].J Neurosurg,2013,118(2):437-443.
[5]肖艳,吕发金.脑动静脉畸形影像诊断新技术进展值[J].放射学实践,2016,31(5):456-459.
[6]李永丽,闫峰山,窦社伟,等.非对比增强四维MR血管成像评价脑动静脉畸形[J].中国医学影像技术,2013,29(5):701-705.