脑内扩张的血管周围间隙的MR诊断  

MRI diagnosis of cerebral enlarged perivascular space

作　　者：刘银社[1] 袁飞[1] 赵军[1] 袁滨[1] 张忠强[1] 艾克文[1] 

机构地区：[1]武警医学院附属医院放射科,天津300162

出　　处：《中国临床解剖学杂志》2010年第4期405-408,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的分析脑内扩张的血管周围间隙(V-R间隙)的MRI表现及解剖学特征,为临床及影像学诊断提供形态学基础。方法回顾性分析29例患者扩张的V-R间隙的发生部位、形态、大小、MR信号、占位效应等MRI表现。结果 29例病人共发现32个病变,30个病变为边缘光滑的圆形、类圆形的囊性病变,1个病变为分叶状囊性病变,1例为簇集样囊性病变;I型(血管周围间隙见于豆纹动脉经前穿支进入基底节处)(34.4%)和Ⅱ型(血管周围间隙分布于脑的穿支动脉进入大脑凸面并延伸至皮质下白质处)(40.6%)最多;其次为脑干(15.6%)和丘脑(9.4%);MRI不同序列显示所有扩张的V-R间隙的信号均与脑脊液信号一致,增强扫描无强化。结论脑内扩张的V-R间隙是与穿支血管走行一致、与脑脊液呈等信号的囊状病变,熟悉其MRI特征有助于与脑内其他囊性病变相鉴别。Objective To delineate the MR imaging features of cerebral enlarged perivascularspace in an effort to prevent misdiagnisis and unnecessary biopsy and operation.Methods Twenty-nine cases with the enlarged perivascular spaces were evaluated retrospectively to determine the location,configuration,size, MR intensity and mass effect.Results There were 32 lesions in 29 patients.Thirty lesions were round or oval cysts with well-defined,smooth margin.One lesion showed a multiloculated cystic mass.One patient showed clusters of variably sized cysts.The most common location was Type I（along the lenticulostriate arteries entering the basal ganglia through the anterior perforated substance）（34.4%）and type II（along the path of the perforating medullary arteries as they enter the cortical gray matter over the high convexities and extend into the white matter）（40.6%）,then was typeⅢ（midbrain and thalamus）（15.6%and 9.4%, respectively）.All lesions had signal intensity comparable to CSF and did not enhance.Conclusions The cerebral enlarged perivascular spaces were oval,rounded or clustered cystic lesions that accompany penetrating arteries and arterioles as they penetrate the brain.The signal intensity of perivascular spaces is identical to that of cerebrospinal fluid with all magnetic resonance imaging sequences.Knowledge of their signal intensity characteristics and localization helps in differentiating them from different pathologic conditions.

关 键 词：脑血管 血管周围间隙 磁共振成像 

分 类 号：R816.1[医药卫生—放射医学]