磁敏感加權成像技術對兒童腦血管畸形的診斷價值

林旭波，吳愛琴，鄭文龍，楊忠福，段偉民，楊于兵，陳通敬

（1.溫州醫科大學附屬第二醫院育英兒童醫院 放射科，浙江 溫州 325027；2.溫州醫科大學附屬蒼南醫院 放射科，浙江 溫州 325800）

磁敏感加權成像技術對兒童腦血管畸形的診斷價值

林旭波1，吳愛琴1，鄭文龍2，楊忠福2，段偉民2，楊于兵2，陳通敬2

（1.溫州醫科大學附屬第二醫院育英兒童醫院 放射科，浙江 溫州 325027；2.溫州醫科大學附屬蒼南醫院 放射科，浙江 溫州 325800）

目的：探討磁敏感加權成像技術（SWI）對兒童腦血管畸形的臨床診斷價值。方法：選取2013年7月至2015年3月溫州醫科大學附屬第二醫院育英兒童醫院腦血管畸形患兒38例，分別行常規MRI和SWI檢查，其中動靜脈畸形11例、腦靜脈畸形8例、海綿狀血管瘤14例（其中多發5例、單發9例）和毛細血管擴張癥5例，7例同時行釓噴酸葡胺增強掃描，比較常規MRI序列與SWI序列對腦血管畸形病灶檢測的差異。結果：38例腦血管畸形病灶在SWI均清晰顯示。動靜脈畸形、海綿狀血管瘤、腦靜脈畸形、毛細血管擴張癥的常規MRI檢出率分別為100.0%、78.6%、37.5%和20.0%，而SWI檢出率均為100.0%。SWI在顯示微出血、引流靜脈及髓靜脈方面明顯優于常規MRI。結論：SWI在兒童腦血管畸形疾病中較常規MRI更多、更清晰地顯示病灶情況，避免部分病灶的漏診，在兒童腦血管畸形診斷中具有重要的臨床價值。

磁敏感加權成像；磁共振成像；腦血管畸形；兒童

Abstract: Objective:To evaluate the diagnostic value of susceptibility weighted imaging (SWI) in cerebral vascular malformations of children.Methods:Thirty eight cases of cerebral vascular malformations of children underwent routine magnetic resonance imaging (MRI) and SWI examination, which included 11 cases of arterio-venous malformations (AVM), 8 cases of cerebral venous malformations (CVM), 14 cases of cavernous hemangiomas (9 cases of solitary and 5 cases of multiple) and 5 cases 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 was compared.Results:Thirty eight cases of cerebral vascular malformations were well-displayed on SWI. The detection rate of conventional MRI in AVM, cavernous hemangiomas, CVM and ICT were 100.0%, 78.6%, 37.5%and 20.0% respectively. While the detection rate of SWI in them were all 100.0%. SWI was obviously superior to conventional MRI on demonstrating microbleed foci, draining veins and medullary veins of cerebral vascular malformations.Conclusion:Comparing with conventional MRI, SWI can clearly show more details and detect more small lesions of cerebral vascular malformations, and avoid the missed diagnosis. It has an important value for the diagnosis and differentiation diagnosis of cerebral vascular malformation in children.

Key words:susceptibility weighted imaging; magnetic resonance imaging; cerebral vascular malformation;children

磁共振血管成像（magnetic resonance angiography，MRA）技術常用時間飛躍法（time-of-flight，TOF）和相位對比法（phasecontrast，PC），其依賴血管流入性增強效應及流空效應，故對于管徑較大、血流較快的血管結構顯示較敏感，但對于管徑小而流速慢的靜脈血管顯示相當不敏感，甚至在磁共振增強或DSA中亦僅部分或完全不顯示。……