颅内动脉夹层的临床和高分辨磁共振管壁成像表现并文献复习  

Clinical and high-resolution MR vessel wall imaging findings of intracranial artery dissection and literature review

作　　者：尚英杰[1] 张斯佳[1] 陈勇[1] 祁佩红[1] 张伟[1] SHANG Yingjie;ZHANG Sijia;CHEN Yong;QI Peihong;ZHANG Wei(Department of Imaging,the People's Hospital of Zhengzhou,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院影像科,河南郑州450003

出　　处：《实用放射学杂志》2020年第7期1031-1034,共4页Journal of Practical Radiology

摘　　要：目的 探讨颅内动脉夹层(IAD)的临床和高分辨MR管壁成像的影像表现.方法 回顾性分析9例IAD的高分辨MR管壁成像的影像资料和临床表现,并结合文献分析其临床和影像特点.结果 9例患者中,头或颈部疼痛4例,眩晕7例,缺血性卒中6例,短暂性脑缺血发作1例;延髓梗死伴或不伴小脑梗死4例,分水岭梗死2例.发病前有外伤史3例,运动史4例,高血压病史2例.9例患者共9处病变,病变部位:大脑中动脉2例,颈内动脉颅内段1例,基底动脉2例,椎动脉颅内段4例.影像特征:偏心狭窄伴外管径扩张9例;显示双腔征7例,内膜瓣5例,壁间血肿7例(壁间血肿呈螺旋状走行1例).结论 IAD好发于有运动史或外伤史的中青年人群,高分辨MR管壁成像的影像表现包括内膜瓣和双腔征、壁间血肿、偏心狭窄伴外管径扩张、夹层动脉瘤等.Objective To investigate the clinical and high-resolution MR vessel wall imaging findings of intracranial artery dissection(IAD).Methods Clinical m anifestations and imaging data of high-resolution MR vessel wall imaging in 9 cases of IAD were reviewed retrospectively,the clinical and imaging features were analyzed with the literature.Results There were 9 patients,in which 4 cases with headache or neck pain,7 cases with vertigo,6 cases with ischemic stroke,1 case with transient ischemic attack,4 cases with medullary infarction with or without cerebellar infarction,and 2 cases with watershed infarction.There were 3 cases of trauma before onset,4 cases of sports history and 2 cases of hypertension.There were 9 lesions in 9 patients,including 2 cases of middle cerebral a rte ry,1 case of intracranial internal carotid artery,2 cases of basilar artery,4 cases of intracranial vertebral artery.Imaging featu res:9 cases of eccentric stenosivS w ith dilation of external diam eter;7 cases of double lum en sign,5 cases of intimal flap,7 cases of intram ural hem atom a(1 case of intram ural hem atom a in spiral shap e).Conclusion IAD is m ost common in middle-aged people with the history of sports or traum a,and the imaging features of high-resolution MR vessel wall imaging include intimal flap and double lumen sign,intramural hematoma,eccentric stenosis with dilation of external diam eter,dissecting aneurysm,etc.

关 键 词：颅内动脉夹层 高分辨磁共振 管壁成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]