3．0T MR磁敏感加权成像对多发性硬化患者脑静脉的研究  

Study of brain veins in patients with multiple sclerosis with 3. 0 T susceptibility-weighted magnetic resonance imaging

作　　者：曾春[1] 李咏梅[1] 罗天友[1] 欧阳羽[1] 吕发金[1] 陈璇[1] 王忠平[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,400016

出　　处：《中华放射学杂志》2011年第5期421-425,共5页Chinese Journal of Radiology

摘　　要：目的探讨磁敏感加权成像（SWI）在检查多发性硬化（MS）患者大脑内静脉及属支和深部髓静脉改变中的价值。方法对43例MS患者和年龄、性别相匹配的43名健康志愿者行常规MRI和SWI，在43例MS患者中，5例病程〈0．5年，17例病程0．5～2．0年，21例病程〉2．0年。SWI所得静脉图像应用MinIP处理后，由2名有经验的医师双盲法评定MS患者大脑内静脉及其主要属支和深部髓静脉的改变，并与对照组比较。统计学分析采用Kruskal WalEs H检验和Wilcoxon秩和检验。结果43例MS患者中，23例为活动期，20例为稳定期。（1）大脑内静脉及其主要属支评分：23例活动期、20例稳定期MS患者及43名健康志愿者分别为（1．96±0．71）、（1．25±0．44）及（3．00±0．00）分，三者间差异均有统计学意义（H=67．65，P〈0．01）；活动期和稳定期MS患者均较对照组降低，差异有统计学意义（Z值分别为-6．67、-7．76，P值均〈0．01），而活动期与稳定期MS患者比较差异也有统计学意义（Z=-3．35，P〈0．01）。（2）侧脑室体旁深部髓静脉改变：38例病程〉0．5年的MS患者（17例病程0．5～2．0年、21例病程〉2．0年）侧脑室体旁深部髓静脉减少、变短；5例病程〈0．5年的MS患者侧脑室体旁深部髓静脉增多、延长。（3）“穿通静脉”表现：23例活动期MS患者中，35个侧脑室体旁强化病灶内“穿通静脉”明显扩张、延长；20例稳定期MS患者中，80个侧脑室体旁未强化病灶内“穿通静脉”变细、变短，但存3例患者中，6个侧脑室体旁未强化病灶内“穿通静脉”扩张、延长。结论SWI能显示MS患者大脑内静脉及其属支和深部髓静脉改变，对了解MS的发病机制及病理改变具有重要价值。Objective To explore the value of susceptibility weighted imaging （SWI） in detecting the changes of cerebral internal veins and their tributaries, especially the deep medullary veins, in the patients with muhiple sclerosis （ MS）. Methods Conventional MRI and SWI were performed in 43 MS patients and 43 healthy volunteers （ control group）. Two groups were matched on gender and age. In the MS patients, the course of disease was less than 0. 5 year in 5 patients, between 0. 5 year and 2.0 years in 17 patients and more than 2.0 years in 21 patients. SWI venograms were obtained by performing minimum intensity projection （MinIP） reconstruction. Comparing with the control group, the changes of the cerebral internal veins, their main tributaries and the deep medullar veins in the MS patients were evaluated by 2 experienced radiologists with double blind methods. Kruskal Wallis H analysis and Wilcoxon rank test were used for statistics. Results In the 43 patients, 23 had active MS （ active group） , 20 had chronic MS （ chronic group）. （ 1 ） The mean score of the cerebral internal veins and their main tributaries was （ 1.96 ±0. 71 ） for 23 active MS patients, （ 1.25 ±0. 44） for 20 chronic MS patients and （ 3.00 ±0. 00） for the control group, respectively. There were significant differences among the three groups （H = 67.65, P 〈 0. 01 ）. And the mean scores in the active and chronic MS patients were lower than that in the control group （1.96±0.71 vs3.00±0.00, Z= -6.67, P〈0.01; 1.25 ±0.44 vs3.00±0.00, Z= -7.76, P〈 0. 01 ） , the mean score in the active MS patients was higher than that in the chronic MS patients （ Z = -3.35 ,P 〈0.01）. （2） The deep medullar veins were shortened or diminished in 38 MS patients whose course of disease were more than 0. 5 year, and increased and prolonged in 5 MS patients whose course of disease were less than 0. 5 year. （3） The ＂ penetrating veins＂ were dilated and prolonged in 35 periventricular enhanced lesions in th

关 键 词：多发性硬化 磁共振成像 脑静脉 

分 类 号：R445.2[医药卫生—影像医学与核医学]