3T三维时间飞越法磁共振血管成像在硬脑膜动静脉瘘诊断中的应用  

3T 3D-TOF magnetic resonance angiography in the diagnosis of dural arteriovenous fistula

作　　者：李宗鸿[1] 刘文[1] 黄清玲[1] 蒋惟伟[1] 张乾[1] 肖朝勇[1] 

机构地区：[1]南京医科大学附属南京脑科医院放射科,210029

出　　处：《临床神经外科杂志》2011年第6期304-306,共3页Journal of Clinical Neurosurgery

基　　金：南京市科技发展项目YKK09126

摘　　要：目的探讨3T三维时间飞越法(3D-TOF)磁共振血管成像(MRA)对硬脑膜动静脉瘘(DAVF)的诊断价值。方法对18例DAVF患者的头颅MRI、3D-TOF-MRA及DSA检查结果进行回顾性对照分析。结果发生部位以后颅凹最为常见(15/18,其中天幕9例,乙状窦及横窦区4例,窦汇区及颈静脉孔区各1例),顶部2例,海绵窦区1例。临床表现呈多样性,以颅内高压(8例)和癫闇(4例)最为常见。MRI以脑出血样混杂信号多见(9/18),可伴周边粗大流空血管影、脑水肿及脑组织萎缩等。3D-TOF-MRA显示供血动脉由颈内外、椎基底动脉共同参与多见(13/18例),6例血管影增多增粗,与DSA所见皮层静脉逆行(CVR)引流相吻合。结论 3T 3D-TOF-MRA结合常规MR影像,能较为准确地确定病灶的部位、供血动脉及皮层引流静脉,同时清晰显示DAVF继发性的颅内改变,弥补了DSA的不足,可对DAVF病变进行无创全面的评价。Objective To explore the diagnostic value on the dural arteriovenous fistula （DAVF） with the 3T three-dimensional time of flight magnetic resonance angiography （3D-TOF- MRA）. Methods The MRI,MRA and DSA images ,sere retrospectively compared and analyzed in 18 patients with DAVF. Results The most common site of DAVF occured in the fossa （ 15/18, 9 cases in tentorial, 4 cases in sigmoid sinus and transverse sinus, 1 case respectively in confluence sinuum and jugular foramen area）, 2 cases in parietal lobe and 1 case in cavernous sinus . The most common clinical manifestations were intracranial hypertension （ 8 cases） and epilepsy （4 cases）. Mixed signals with brain hemorrhage （9/18） were dearly seen, and other lesions such as peripheral vascular flow void signal, cerebral edema and brain atrophy could be depicited on MRI. 3D-TOF- MRA could show feeding artery from the internal external carotid, vertebral basilar artery blood supply to participate in common（ 13/18cases）, 6 cases of increased blood concentration is consistent with DSA findings of retrograde cortical vein （CVR） drainage. Conclusion 3T 3D-TOF-MRA combination with conventional MR imaging can accurately determine the lesion site, feeding artery, cortical venous drainage and clearly show the secondary intracranial DAVF change, and make up a comprehensive evaluation on the DAVF.

关 键 词：硬脑膜动静脉瘘 三维时间飞越法磁共振血管成像 数字减影血管造影 

分 类 号：R743.3[医药卫生—神经病学与精神病学]