磁敏感加权成像SWAN序列在儿童颅脑疾病中的应用价值  

Value of MR susceptibility weighted angiography(SWAN)imaging in the diagnosis of brain diseases in children

作　　者：陈静[1] 李欣[1] 王春祥[1] 赵滨[1] 刘俊刚[1] 

机构地区：[1]天津市儿童医院影像科,天津300074

出　　处：《放射学实践》2014年第8期867-871,共5页Radiologic Practice

摘　　要：目的:探讨MR磁敏感加权T2*加权血管成像(SWAN)在儿童颅脑疾病诊断中的应用价值。方法:经临床确诊的颅脑疾病患儿77例,其中新生儿缺氧缺血性脑病(HIE)伴出血性病变8例,颅脑外伤47例,脑血管畸形22例。所有患儿均行SWAN序列及常规MRI平扫,16例行增强扫描。所有图像由3位有经验的影像诊断医师进行评估。结果:SWAN序列对HIE伴出血性病变中脑实质内微出血、室管膜下出血、脑室内积血及蛛网膜下腔出血的显示优于常规MRI序列;对颅脑外伤中脑挫裂伤、弥漫性轴索损伤、蛛网膜下腔出血的显示优于MRI常规序列,对硬膜下血肿和硬膜外血肿的显示欠佳;对脑血管畸形的显示优势主要体现在海绵状血管瘤、发育性静脉异常和Sturge-Weber综合征中,发现海绵状血管瘤的数量明显增多,尤其是体积较小的海绵状血管瘤,可发现隐匿性的发育性静脉异常及Sturge-Weber综合征脑表面的异常血管网。结论:SWAN序列对血管畸形、出血及血液代谢产物的显示有较高的敏感性和特异性,是儿童颅脑疾病MRI检查常规序列的重要补充。Objective： To evaluate the diagnostic value of MR T2 star weighted angiography （SWAN）in pediatric brain diseases. Methods： 77 pediatric patients with clinically diagnosed brain diseases were included in this study. Among them, 8 cases had hypoxic ischemic encephalopathy （HIE） accompanied with hemorrhage,47 cases had cranio-cerebral trauma and the rest 22 cases had vascular malformation of brain. All underwent conventional plain MR examination with SWAN se- quence, whereas 16 cases of them were further examined with contrast-enhanced MR scanning. The images were evaluated by three experienced radiologists. Results： SWAN sequence was superior to conventional sequences in demonstrating HIE with hemorrhage including intra-cerebral parenchymal microhemorrhage, subependymal hemorrhage, intra-ventricular hemorrhage and subarachnoid hemorrhage as well as in demonstrating cranio-cerebral trauma including contusion and lacera- tion of brain,diffuse axonal injury and subarachnoid hemorrhage. However,subdural and epidural hematoma were less con- spicuous on SWAN. As for vascular malformation of brain, the advantages of SWAN were showed in demonstrating caver- nous hemangioma, especially small hemangioma, and were obviously more in number;also in displaying occult developmental vein anomaly and abnormal vascular network at the brain surface of Sturge-Weber Syndrome. Conclusion： SWAN sequence is more sensitive and specific in detecting vascular malformation, hemorrhage and blood metabolic products. It is an important supplemental MR sequence in addition to conventional MRI sequences in the diagnosis of pediatric brain diseases.

关 键 词：磁敏感加权成像 T2 加权血管成像 颅脑疾病 儿童 

分 类 号：R445.2[医药卫生—影像医学与核医学]